JP2011509117A - Intraluminal filter having a fixation device - Google Patents

Abstract

A first support member having a first end and a second end; and a first support member mounted on the first end of the first support member or the second end of the first support member and An intraluminal filter including a second support member that forms a crossover to the one support member. The intraluminal filter includes a material capture structure extending between the first and second support members, the crossover and the first end or the second end of the first support member; And at least one tissue anchor on the support member or the second support member. A method of placing a filter within a lumen includes advancing a sheath holding the filter through the lumen. Next, a portion of the filter is deployed from the sheath into the lumen to engage the lumen wall while maintaining substantially all of the filter material capture structure within the sheath. Next, the filter material capture structure is deployed across the lumen.
[Selection] Figure 88

Description

Cross-reference of related applications

[0001] This application is filed in US Provisional Patent Application No. 60 / 641,327, filed January 3, 2005, US Provisional Patent Application No. 60/668, filed April 4, 2005, No. 548, 2006 under the name “Endoluminal Filter” claiming benefits based on US Provisional Patent Application No. 60 / 673,980 filed Apr. 21, 2005. Which is a continuation-in-part of U.S. Non-Provisional Patent Application No. 11 / 325,230 [Lawyer Case No. 10253-701.201] filed on January 3, each of the above-mentioned U.S. patent applications This application is incorporated by reference and is incorporated herein by reference, and is also filed on the following co-pending US patent application filed January 3, 2006: No. 11/325/661 [Lawyer Case No. 10253-701.203], entitled “Retrievable Endoluminal Filter”, “Coated Endoluminal Filter”. No. 11 / 325,611 [Lawyer Case No. 10253-701.202], US Patent Application No. 11/345, entitled “Spiral Shaped Filter”. No. 325,229 [Lawyer Case No. 10253-701.204], US Patent Application No. 11 / 325,273 entitled “Filter Delivery Methods” No. 10253-701.206], U.S. Patent Application No. 11 / 325,249 entitled "Methods for Maintaining A filtering Device Witha Lumen". Description [Lawyer Case No. 10253-701.207] and US Patent Application No. 11 / 325,247 entitled “Lumen Filtering Methods” [Lawyer Case No. 10253-701]. .208], each of which is hereby incorporated by reference in its entirety.

[0002] The present invention relates generally to an apparatus and method for filtering debris in a body cavity. More specifically, the present invention provides a recoverable filter that is placed percutaneously in a patient's vascular tissue to prevent the passage of an embolus. Furthermore, embodiments of the present invention provide a filter that can be placed non-wound and then percutaneously removed from the blood vessel using one end of the filter.

[0003] Embolism protection is used throughout the vascular tissue to prevent embolic material in the bloodstream from passing through thin blood vessels, blocking the blood flow in the thin blood vessels and causing fatal injury. Embolization translocation often occurs with methods of opening blood vessels to restore natural blood flow, such as stenting, angioplasty, arthrotomy, endarterectomy, and thrombectomy . When used as an adjunct to these methods, embolism protection devices provide a means to capture debris and remove it for the body.

U.S. Pat. No. 3,540,431 US Pat. No. 3,952,747 US Pat. No. 5,133,733 US Pat. No. 6,258,026 US Pat. No. 6,443,972 US 2004/0186512 US Pat. No. 6,388,043 US Pat. No. 6,160,084

Kinney TB's Update on Inferior Vena Cava Filters, JVIR 2003; 14: 425-440 Vena cava filter to prevent pulmonary embolism in Arch of Surg 1963; 86: 852-868 by Dewesse MS

  [0004] One widely used embolic protection practice is to place the filtering means in the vena cava. A vena cava filter (VCF) prevents thrombus from the deep veins of the leg from entering the bloodstream and eventually reaching the lungs. This condition is known as deep vein thrombosis (DVT), which can be fatal wound known as pulmonary embolism (PE).

[0005] The first surgical treatment of PE performed by John Hunter in 1874 is ligation of the femoral vein. The next important advance developed in the 1950s is the method of compartmentalizing the vena cava using clips, sutures or staples. These methods are effective in preventing PE, but with significant mortality and morbidity. (For example, Kinney TB's JVIR 2003; 14: 425-440 pages on the latest inferior vena cava filter (Update on inferior vena cava filters). See
[0006] An important advance in PE treatment, in which venous blood flow is maintained, was realized in 1955 by DeWesse. This method is referred to as a “Harp-string” filter, as shown in FIGS. 1A and 1B, where the vena cava is within the tangent plane below the renal vein 13 to capture the thrombus. 11, the strands of silk suture 12 were sutured. There are reports of clinical results demonstrating the effectiveness of this method in preventing PE and maintaining vena cava patency (eg, Dewesse MS, the contents of which are incorporated herein by reference) According to Arch of Surg 1963; 86: 852-868, for the prevention of pulmonary embolism (see A vena cava filter for the prevention of pulmonary emboli). The surgical mortality associated with all of these surgical treatments is still high, which limits their application.

  [0007] The current generation lower aortic (IVC) filter was first introduced in 1967 with the development of the Mobin-Uddin umbrella 21 (FIG. 1C) described in more detail in US Pat. No. 3,540,431. Appeared. A green field filter (FIG. 1D) was developed in 1973 and is described in more detail in US Pat. No. 3,952,747. These conical devices were placed in the lumen within the IVC and utilized hooks or hooks 20, 30 to puncture the IVC wall and fix the position of the device. Currently, various conical percutaneous vena cava filters based on this concept are available. For example, TULIP (FIG. 1E) having a filter structure 41 further described in US Pat. No. 5,133,733, filter structure 51 described in US Pat. No. 6,258,026 (FIG. RECOVERY with FIG. 1F), TRAPESE with filter structure 61 (FIG. 1G) described in US Pat. No. 6,443,972.

  [0008] The next advances in filters added an element of recoverability. The recoverable filter was designed to allow it to be removed from the patient after initial placement. Retrievable filters as a whole are effective in preventing PE, but still cannot be properly deployed in blood vessels, for example, move, puncture vessel walls, and break support structures And there are a number of disadvantages, such as being limited to a particular situation, and the fact that a thrombus is formed in or around the device.

  [0009] The problems with recoverable conical devices such as those shown in FIGS. 1D, 1E, and 1F are described in the medical literature. These reported problems include tilting which makes it difficult to recapture the device and impairs the filtration capacity. It has been reported that the hooks 30, 40, 50, 60 used to secure these devices are difficult to puncture and feed the vessel wall and cause breakage. A partially recoverable system is described in detail in pending US 2004/0186512 (FIG. 1H). In this system, the filter portion 71 can be removed from the support structure 70, but the support structure remains in the body. All of these described devices have a common difficulty that they can only be recovered from one end. Each of the papers, patents, and patent applications mentioned above is incorporated herein by reference.

  [0010] In view of the numerous shortcomings and challenges still unresolved in the field of intraluminal filtration, there remains a need for improved and recoverable intraluminal filters.

  [0011] In one feature of the invention, a first support having a first end and a second end, and a first support on or at the first end of the first support member. A second support mounted on a second end of the member and forming a crossover having a first support member; first and second support members; a crossover; and a first support member An intraluminal filter having a material capture structure extending between the first end or the second end of the first and second tissue anchors provided on the first support member or the second support member Is provided. In one feature, the second support member is attached to the first end of the first support member and the second end of the first support member. In one feature, the first support member and the second support member are formed of a single wire. In one feature, the first support member forms a tissue anchor and the second support member forms a recoverable feature. In one feature, there is a recoverable feature at the first end and a recoverable feature at the second end. In another feature, there is a combined tissue anchor and a recoverable feature coupled to the first end or the second end of the first support member. In another feature, there is a mounting element that couples the first support member to the second support member. In one alternative, the attachment element includes a tissue anchor. In one feature, at least one tissue anchor is formed on the surface of the first support member or the second support member. In one feature, at least one tissue anchor on the first support member or the second support member is disposed between the crossover and the first end or the second end. In another feature, the tissue anchor comprises one or more tissue anchors at a location on the first or second support member. In another feature, the tissue anchor is formed from or attached to a tube that covers at least a portion of the first support member or the second support member. In another feature, the tissue anchor is a tube having a tissue engaging surface. In one embodiment, the tissue engaging surface has a raised configuration. In one alternative, the raised configuration comprises a helical configuration. In another feature, the tissue anchor comprises a coil wound around a first or second support member having at least one end adapted to puncture tissue.

  [0012] In another embodiment, a first support member having a first end and a second end, a second end having a first end and a second end. A support member, a first support member, a second support member, a point where the first end of the first support member is coupled to the first end of the second support member, and the first A filter structure suspended between a crossing point without the support member being coupled to the second support member; and a second end of the first support member or a second end of the second support member. A filter having a tissue anchor at at least one of its ends. In one feature, the tissue anchor is at the point where the first end of the first support member joins the first end of the second support member. In one feature, the tissue anchor is formed from a first support member or a second support member. In another feature, there is also a recoverable feature at the point where the first end of the first support member joins the first end of the second support member. In one alternative, the recoverable feature is formed from a first support member or a second support member. In another feature, a third support member having a first end and a second end, a first end and a second end, and coupled to the third support portion. The second end of the third support member is attached to the second end of the second support member, and the second end of the fourth support member is , Attached to the second end of the first support member. In one alternative, a tube is used to couple the third support member to the second support member or the first support member to the fourth support member. In another alternative, the tube includes a tissue engaging feature.

  [0013] In one embodiment, the sheath holding the filter is advanced through the lumen, and a portion of the filter is lumened from the sheath while substantially maintaining the filter material capture structure within the sheath. A method of placing a filter in a lumen comprising deploying and engaging a lumen wall within the filter, and deploying a material capture structure of the filter from the sheath to a position across the lumen. is there. In one aspect, there is also the step of deploying the filter crossover structure in the lumen before or after the step of deploying the filter material capture structure. In another feature, maneuvering the snare toward the filter in the same direction as the direction used during the advancing step, or vice versa, and retrieval of the filter positioned against the lumen wall And engaging with possible features. In one feature, there is also the step of deploying the recoverable features of the filter from the sheath prior to the step of deploying the material capture structure. In one feature, there is also the step of deploying the recoverable features of the filter from the sheath prior to the step of placing the material capture structure. In one feature, there is the step of deploying the recoverable features of the filter from the sheath after and before deploying the material capture structure. In one alternative, the step of deploying the recoverable feature includes disposing the recoverable feature of the filter opposite the lumen wall. In one alternative embodiment, deploying a portion of the filter includes engaging the lumen wall with a fixation device attached to the filter. In another alternative, deploying a portion of the filter includes engaging the lumen wall with a radial force generated by the filter support structure.

  [0014] The features and advantages of embodiments of the present invention may be better understood with reference to the following detailed description and accompanying drawings that illustrate exemplary embodiments.

Various prior art filters are shown. Fig. 5 shows the responsiveness of the filtration device to changes in lumen dimensions. Fig. 5 shows the interaction between the lumen wall and the structural member. Fig. 5 shows the interaction between the lumen wall and the structural member. Fig. 5 shows the interaction between the lumen wall and the structural member. Various features of the structural members in the filtration device are shown. Various features of the structural members in the filtration device are shown. Various features of the structural members in the filtration device are shown. The various features of a planar support frame as a whole are shown. Various features of a non-planar support frame are shown. Various features and forms of the material capture structure are shown. Various features and forms of the material capture structure are shown. Various features and forms of the material capture structure are shown. Various features of a filtration device with three support frames are shown. The symmetry plane for the filtration device is shown. The responsiveness of the filtration device when the residue flowing in the lumen comes into contact is shown. Fig. 4 shows an alternative filtration device feature with different sized support frame and structural member lengths. Fig. 4 shows an alternative filtration device feature with different sized support frame and structural member lengths. Fig. 4 shows an alternative filtration device feature with different sized support frame and structural member lengths. Various alternative techniques for connecting the ends of the filtration device and the structural members are shown. Various alternative techniques for connecting the ends of the filtration device and the structural members are shown. Various alternative techniques for connecting the ends of the filtration device and the structural members are shown. Various alternative techniques for connecting the ends of the filtration device and the structural members are shown. Various alternative techniques for connecting the ends of the filtration device and the structural members are shown. Various alternative recoverable features are shown. Various alternative recoverable features are shown. Various alternative recoverable features are shown. Various techniques for connecting or forming recoverable features are shown. Fig. 5 shows a filtration device with a recoverable feature disposed in the lumen. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative techniques for connecting a material capture structure to a support frame and forming a filtration structure are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Several alternative filtration structures are shown. Various forms of filtration equipment are shown. Various forms of filtration equipment are shown. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Demonstrates various techniques related to filtration device infeed, recovery and repositioning. Several exemplary methods of using a filtration device are shown. Several exemplary methods of using a filtration device are shown. Several exemplary methods of using a filtration device are shown. Several exemplary methods of using a filtration device are shown. Fig. 2 shows some alternative filtration device configurations that allow delivery of drug. Fig. 2 shows some alternative filtration device configurations that allow delivery of drug. Fig. 2 shows some alternative filtration device configurations that allow delivery of drug. Fig. 2 shows some alternative filtration device configurations that allow the drug to be delivered. The prototype of several filtration apparatuses is shown. The prototype of several filtration apparatuses is shown. The prototype of several filtration apparatuses is shown. The prototype of several filtration apparatuses is shown. The prototype of several filtration apparatuses is shown. FIG. 6 is a perspective view of an intraluminal filter having three tissue anchors. FIG. 89C shows the individual filter components that can be assembled into the final configuration shown in FIG. 89C. FIG. 89C shows the individual filter components that can be assembled into the final configuration shown in FIG. 89C. It is a perspective view of the filter finally assembled. Figure 8 shows the proximal and distal ends of a filter with the elongate member tip modified to form a securing element. Figure 8 shows the proximal and distal ends of a filter with the elongate member tip modified to form a securing element. FIG. 90B is a perspective view of a filter assembly using the proximal and distal ends of FIGS. 90A and 90B. FIG. 90B is a perspective view of a filter device formed by connecting the device shown in FIG. 90A to the device shown in FIG. 90B. Fig. 4 shows a fixation element formed at the end of an elongated body. FIG. 2 is a perspective view and a cross-sectional view, respectively, of a prior art securing element having a transition portion and a reduced diameter portion. FIG. 2 is a perspective view and a cross-sectional view, respectively, of a prior art securing element having a transition portion and a reduced diameter portion. Fig. 4 illustrates one embodiment of the proximal end of a filter structure formed from a single wire. FIG. 104B illustrates one embodiment of the proximal end of a filter structure formed from a single wire with the securing element of FIG. 104A. FIG. 99 shows a filter device with a fixation element used in the lumen with the filtration structure in an upstream position (FIG. 96) and a downstream position (FIG. 97). FIG. 99 shows a filter device with a fixation element used in the lumen with the filtration structure in an upstream position (FIG. 96) and a downstream position (FIG. 97). Fig. 6 shows a fixation element engaged with a lumen sidewall. Fig. 4 shows a support frame without a material capture structure showing the placement and orientation of various fixing elements. Fig. 5 shows a state in which the fixing element is arranged at a substantially intermediate distance between the end portion and the crossover. FIG. 100 shows an arrangement of fixation elements similar to FIG. 100, with additional fixation elements arranged near the crossover and ends. Fig. 3 shows one or more anchoring elements arranged at the same position along the filtration device. FIG. 10C shows the placement of the fixation element on the elongated body (FIG. 103A) or on one side of the elongated body (FIGS. 103B and 103C). Shown is an anchoring element with both ends (FIG. 104A) and a state of attaching the anchoring element with both ends to the elongated body (FIG. 104B). Shown is an anchoring element with both ends (FIG. 104A) and a state of attaching the anchoring element with both ends to the elongated body (FIG. 104B). Fig. 6 shows a fixed element with different ends with different tip orientations attached to an elongated body. FIG. 6 illustrates an embodiment of a tissue anchor having one end raised above the support member. FIG. 6 illustrates an embodiment of a tissue anchor having one end raised above the support member. Figure 3 shows a tissue anchor attached to a tube attached to a support member. FIG. 107B shows a plurality of tissue anchors shown in FIG. 107A disposed along a pair of support structures. Fig. 3 shows a tissue anchor formed in a tube positioned above the elongated body or other portion of the filtration device. Figure 3 shows a tissue anchor formed by cutting into an elongated body. FIG. 5 is a perspective view of a tube whose surface has been modified to provide tissue engaging features. Fig. 4 shows an alternative securing feature that can be attached to the wall of the tube, inside or through the wall. FIG. 5 is a perspective view of a fixation element based on a tube having a spiral configuration when raised. FIG. 6 is a perspective view of one end of a filtration device in which the recoverable feature includes a tissue engagement feature. FIG. 6 is a perspective view of one end of a filtration device with a recoverable feature ending in a fixed or mounted feature. FIG. 10 is a perspective view of one end of a filtration device with a recoverable feature ending in a fixed or mounting feature and an end of an elongated support structure formed in a tissue engaging element. FIG. 5 is a perspective view of one end of a filtration device with an elongated body end formed through a fixed or mounting feature and a retrievable feature and tissue engaging element. FIG. 116B is a cross-sectional view of the securing or mounting feature shown in FIG. 116A. FIG. 16B is a cross-sectional view of the fixation or attachment feature of FIG. 16A provided with separate tissue engaging and recoverable features not formed at the end of the elongated support structure. A perspective view of one end of the filtration device, wherein the end of one elongated body is formed into a retrievable feature through the fixed or mounted feature and the tissue engaging element is formed in a portion of the fixed or mounted feature. A figure and a bottom view are shown. FIG. 5 is a perspective view of a separate tissue engagement feature connected to a filtration device using a fixation or attachment feature. FIG. 99 illustrates an alternative embodiment of the tissue engaging element of FIG. 98 with the addition of a hollow tip portion. FIG. 93 shows an alternative embodiment of the tissue engaging element of FIGS. 93A and 93B with the addition of a hollow tip portion. FIG. 11B shows an alternative embodiment of the tissue engaging element of FIGS. 111A and 111B with the addition of a hollow tip portion. FIG. 11B shows an alternative embodiment of the tissue engaging element of FIGS. 111A and 111B with the addition of a hollow tip portion. FIG. 12B shows a perspective view of a filter device positioned for deployment, which is in the lumen and the filter device is stored in the deployment sheath (FIG. 123A). The filter device is shown in phantom in the diagram shown in FIG. 123B. An example filter placement and deployment procedure is shown. One approach and recovery procedure for recovering the deployed filtration device is shown. One approach and recovery procedure for recovering the deployed filtration device is shown.

  [0079] There remains a clinical need for improved intraluminal filter devices and methods. The improved intraluminal filter device provides effective filtration over a range of lumen tube sizes and can be easily deployed and retrieved from the lumen. Furthermore, the improved intraluminal filter device minimizes thrombus formation or tissue ingrowth in the device and resists movement along the lumen. Embodiments of the filter device of the present invention provide many of the features of the improved intraluminal filter, and possibly all of them, and also embolism protection, thrombectomy, vaso-occlusion methods And a number of uses including, but not limited to, protecting the ends of knots or knots.

  [0080] Some embodiments of the present invention are durable over a range of dimensions, provide an effective and nearly constant filter capability, and are easily fed from the lumen through one end of the device. And an improved filtration device that can be removed. Furthermore, embodiments of the present invention can be fed into and retrieved from a lumen using minimally invasive surgical techniques. One feature of the present invention is to produce a support structure using a shape memory material. The shape memory material allows the support element to fold evenly and provides a predetermined range of controllable force against the lumen wall without the use of hooks or hooks when deployed. It can have a form of a predetermined shape that guarantees that. Alternatively, hooks, hooks or other securing elements or devices can be used with the filtration device embodiments, as described below.

  [0081] The elongated support structure elements are configured to fold and expand with natural vessel movement while maintaining a constant juxtaposition with the vessel wall. One result is that the shape and size of the support structure follows the movement of the blood vessel. As a result, the filter density and capacity of embodiments of the present invention are relatively unaffected by changes in vessel dimensions. Furthermore, the natural centering feature of the support structure will ensure that the filtration device provides a uniform filtration across the diameter of the vessel. Thus, embodiments of the present invention allow filtration capacity to be maintained over the entire lumen of the blood vessel and while the blood vessel contracts and dilates.

  [0082] Uniform filter capability is an important improvement over conventional devices. Conventional devices typically have a filtering capability that varies radially across the lumen. The change in filter capacity in the radial direction is usually due to the fact that conventional filtration elements are generally wider at the periphery of the lumen and narrower along the central lumen axis. To do. As a result, large emboli may escape along the periphery of the lumen. The radial change in filter capacity while the blood vessel expands and contracts is exacerbated with conventional devices.

  [0083] Another advantageous effect of some embodiments of the present invention is that when released from a restricted state (ie, when in a delivery sheath), the device follows the device in a blood vessel. And having a elongated support member that naturally expands and naturally centers the device. These elongated support members apply a non-wounding radial force against the vessel wall to prevent or minimize movement of the device. In some embodiments, the radial force generated by the elongated support member works with hooks, hooks or other fixation devices to secure the device within the blood vessel. Hooks, hooks or other fixation devices or elements can be used as an additional precaution against movement of the filtration device while in the lumen. When the device is retrieved, the uniformly foldable configuration of the elongated support member causes the elongated support member to be pulled away from the vessel wall when the device is re-sheathed. Movement of the elongated support member away from the vessel wall facilitates non-wound removal of the device from the vessel wall. Further, in those embodiments having hooks, hooks or other fixation devices or elements, the movement of the elongated member during retrieval also facilitates withdrawal of the fixation element from the lumen wall.

[0084] Additional embodiments of the present invention may include recoverable features at one or both ends of the device. Using recoverable features at one or both ends of the device allows the device to be deployed, repositioned and removed from both ends of the device. As a result, using recoverable features at one or both ends of the device allows for the use of both antegrade or retrograde approaches in a single device. The recoverable feature can be integrated with another structural member or a separate component. In some embodiments, the recoverable features are foldable and can be curved or generally sinusoidal. Additional features of the recoverable features are described below.
Overall Parts and Structure [0085] FIG. 2A shows one embodiment of the filtration device 100 of the present invention disposed within the lumen 10. Lumen 10 is cut away to indicate the position of filter 100 deployed within the lumen and in contact with the lumen wall. Filter 100 includes a first elongate member 105 and a second elongate member 110. These elongate members are joined to form ends 102, 104. These elongate members intersect at the crossover 106 but do not bond to each other. In one embodiment, these elongate members have first and second portions. The first portion extends between end 102 and crossover 106 and the second portion extends from crossover 106 to second end 104. While some embodiments contact the lumen in a different manner, the illustrated embodiment has ends 102, 104 relative to one side of the lumen inner wall, while the crossover 106 is In contact with the opposite side of the inner wall of the lumen, the elongate body is in a constant or nearly constant juxtaposition along the inner wall of the lumen between the ends 102, 104.

  [0086] Material flowing through the lumen 10 that is larger than the filtration size of the material capture structure 115 (ie, thrombus, plaque, etc.) is captured or lubricated between the filaments 118. In the illustrated embodiment of FIG. 2A, the material capture structure 115 is supported by a rounded frame formed by elongated members 105, 110 formed between the end 102 and the crossover 106. . Another rounded frame formed between the crossover 106 and the second end 104 also supports a support structure of material having the same or different structure and filter capability as the material capture structure 115. It can also be used to Accordingly, the material removal structure supported by one rounded frame is configured to remove material of the first dimension and the material removal supported by the other rounded frame. The structure can be configured to remove material of the second dimension. In one embodiment, the material removal structure in the upstream rounded frame removes larger size debris than the material removal structure in the downstream rounded frame. 2A-2C also show that the filter cells 119 that make up the material capture structure 115 are relatively independent of the movement of the first and second structure members 105, 110 over the physiological diameter range of the blood vessel. It is shown how to maintain the dimensions and shape.

  [0087] FIGS. 2B and 2C show how the elongated support structure of an embodiment of the present invention can be folded and expanded with natural vessel motion while maintaining a constant juxtaposition with respect to the vessel wall. . 2A, 2B and 2C also show that the device according to an embodiment of the invention is elastic both radially and axially. In response to changes in vessel size, the ends 102, 104 move outward with decreasing vessel size (FIG. 2B) and then move inward with increasing vessel size (FIG. 2C). Furthermore, the height “h” of the device (measured from the lumen in contact with the ends 102, 104 to the crossover) also changes. The device height “h”, which is directly related to the change in vessel diameter, changes (ie, an increase in vessel diameter increases the device height “h”). Thus, the height (“h”) of the device in FIG. 2C is higher than the height (“h”) of the device of FIG. 2A, while the height (“h”) of the device of FIG. Higher than the height of the device ("h").

  [0088] FIGS. 2A, 2B, and 2C illustrate how a single dimension device can be used to receive three different diameter lumens. FIG. 2C shows a large lumen, FIG. 2A shows a medium size lumen, and FIG. 2B shows a small size lumen. As these drawings make clear, one device can be able to cover a range of vessel dimensions. In order to cover the range of the inner diameter of the human vena cava with a range of about 12-30 mm and an average inner diameter of 20 mm, only three device dimensions are considered necessary. The static or near static filter capability of the material capture structure 115 is also shown. In each of the different vessel dimensions, the material capture structure 115, filter 118, and filter cell 119 maintain the same or nearly the same shape and orientation within the support structure formed by the elongated body. These figures also show changes in the dynamic shape of the device that can be used to accept and obey vessel irregularities, meanders, spreads and tapers while remaining juxtaposed to the wall. The characteristics of are also shown. Since each of the elongate bodies can move with a high degree of independence from each other, the loops or support frames formed by the elongate bodies are also the lumen portions in which these loops or support frames are disposed. Can be independently adapted to the shape / diameter of

  [0089] FIGS. 3, 3A, and 3B show the device 100 deployed within the lumen 10. FIG. As shown in FIG. 3, the device 100 is oriented in the lumen with the ends 102, 104 along one side of the vessel inner wall and the crossover 106 on the opposite side. Yes. FIG. 3 illustrates one embodiment of the device of the present invention configured to fit within the lumen 10 without dilating the lumen. In FIG. 3A, the elongate bodies 105, 110 are in contact at the crossover 106 but are not joined. In FIG. 3B, the elongate bodies 105, 110 intersect each other at the crossover 106, but are separated (ie, only by the gap “g”).

  [0090] FIGS. 4 and 5 illustrate how the features of the device can be modified to increase the radial force applied to the inner wall of the lumen 10. Devices with increased anchoring force are useful in some applications such as vascular occlusion or end protection where large amounts of debris are expected. If the device is not intended to be retrieved (i.e. permanently installed in the lumen), a device with a high radial force can be used to ensure that the device stays in place, Dilation can also be used to excite the body's response within the lumen (ie, the tissue ingrowth response) to ensure integration with the device ingrowth and lumen inner wall.

  [0091] Embodiments of the filter device of the present invention having low or non-wounding radial forces are particularly useful in recoverable devices. As used herein, a non-wounding radial force is a radial force generated by an embodiment of a filtration device that satisfies one or more of the following: little or no movement. A radial force large enough to hold the device in place without damaging or over-expanding the inner wall of the lumen, exciting little or no body response to the vessel wall Means a force generated by actuation of the device that excites a radial force that is large enough to hold the device in place, or a reduced body response or a smaller body response than conventional filters To do.

  [0092] Unlike the device sized in FIG. 3 to minimize vessel dilation, FIG. 4 shows a device 100 configured to apply a greater radial force to the extent that the lumen wall is dilated. . 4 and 5 show lumen wall dilations such as dilation by end 102 (dilation 10b), dilation by crossover 106 (dilation 10a) and dilation by end 104 (dilation 10c). Although not shown in these drawings, an elongated body can also cause the lumen to expand along its length.

  [0093] The radial force of the device can be increased by using a number of design factors. The radial force can be increased, for example, by increasing the rigidity of the elongated body by using a larger diameter elongated body. The radial force can also be increased when forming the shape of the elongated body (ie, during the heat treatment / curing process for such as a Nitinol device) and in terms of material composition and morphology.

  [0094] Additional details of embodiments of the support members 105, 110 can be understood with reference to FIGS. 6A, 6B, and 6C. 6A and 6B show the support members separated and then assembled together (FIG. 6C) around the axis 121 of the device. Generally, the device axis 121 is identical to the axis along the center of the lumen within which the device is deployed. For illustrative purposes, the support members 105, 110 will be described with respect to a cross-sectional lumen shown in phantom having a generally cylindrical shape. The support member is considered to be deployed within the imaginary cylinder and / or extend along its surface.

  [0095] In the exemplary embodiment of FIGS. 6A, 6B and 6C, the support members 105, 110 are shown in an enlarged, predetermined shape. In one embodiment, the support member is formed of an MRI compatible material. The support member does not have sharp bends or corners that cause fatigue problems, stress increases leading to vessel erosion, and facilitates folding the device. In some embodiments, each elongate member is conventionally shaped like a shape memory metal alloy or shape memory polymer on a cylindrical molding material with pins that regulates the material to a desired shape. , Formed by regulating shape memory material. The material can then be subjected to a suitable conventional heat treatment to define the shape. For example, one or more planes of symmetry (ie, FIG. 15) can be provided by forming both elongated members on a single mandrel and simultaneously. Other conventional processing techniques can also be used to produce symmetric filtration device embodiments. Furthermore, the recoverable features described herein (if present) can be formed directly on the wire end during processing of the support member. In addition, these methods can be used to form multiple devices in succession on long mandrels.

  [0096] Examples of suitable shape memory alloy materials include, for example, copper-zinc aluminum, copper-aluminum-nickel, and nickel-titanium (NiTi or Nitinol) alloys. Nitinol support structures produce a number of working prototypes of the filter device of the present invention and can be used in current animal studies and human implants. Shape memory polymers can also be used to form components of embodiments of the filter device of the present invention. In general, one component, oligo (e-caprolactone) dimethacrylate, provides a crystallizable “switching” segment that determines both the temporary and permanent shape of the polymer. By varying the amount of n-butyl acrylate in the comonomer or polymer network, the crosslink density can be adjusted. In this way, the mechanical strength and the transition temperature of the polymer can be specifically adjusted over a wide range. Further details of shape memory polymers are described in US Pat. No. 6,388,043, which is incorporated herein by reference in its entirety. Furthermore, the shape memory polymer may be a degradable design. Biodegradable shape memory polymers are described in US Pat. No. 6,160,084, which is hereby incorporated by reference in its entirety.

  [0097] Biodegradable polymers are also considered suitable for forming the components of the filter device of the present invention. For example, the biodegradable polymer, polylactide (PLA), has been used in a number of medical device applications, including, for example, tissue screws, tacks, suture anchors, and systems for meniscal and cartilage repair. For example, polylactide (PLA), polyglycolide (PGA), poly (lactide-co-glycolide) (PLGA), poly (e-caprolactone), polydioxanone, polyanhydride, trimethylene carbonate, poly (β-hydroxybutyrate) A variety of synthetic biodegradable polymers are available, including poly (g-ethyl glutamate), poly (DTH imino carbonate), poly (bisphenol A imino carbonate), poly (orthoester), polycyanoacrylate, and polyphosphazene It is. In addition, there are a number of biodegradable polymers available from natural sources such as modified polysaccharides (cellulose, chitin, dextran) or modified proteins (fibrin, casein). The most widely used compounds in commercial applications are PGA and PLA, followed by PLGA, poly (e-caprolactone), polydioxanone, trimethylene carbonate, and polyanhydride.

  [0098] Although described as forming a support structure, it should be understood that other parts of the filter device may be formed of a shape memory alloy, shape memory polymer, or biodegradable polymer. Other filter device components that can also be formed from shape memory alloys, shape memory polymers or biodegradable polymers include, for example, recoverable features, material capture structures or material capture structures and support structures. Including all or part of the mounting part between. Additionally or alternatively, the devices described herein may be formed of medical grade stainless steel, all or part of their components.

  [0099] FIG. 6A shows the first support member 105 extending from one end 102 to one end 104 in a clockwise direction around the inner wall of the lumen (cross-sectional phantom line) and the axis 121 of the device. The support member 105 starts from the end 102 of the part 1 at the 6 o'clock position, passes through the 9 o'clock part 2, the 12 o'clock position of the part 3 and the 3 o'clock position of the part 4 at 6 o'clock in the part 5 It extends to the end 104 of the position. The support member 105 has two portions 120 and 122 on both sides of the bent portion 124. The bending point 124 is arranged at a position of about 12 o'clock in the portion 3. The radii of curvature of the portions 120, 122 can be the same or different. The cross-sectional shape of the support member 105 is generally circular, but in alternative embodiments, it can have one or more different cross-sectional shapes.

  [00100] FIG. 6B shows the second support member 105 extending counterclockwise from one end 102 'to one end 104' around the inner wall of the lumen (cross-sectional phantom line) and the axis 121 of the device. The support member 110 passes from the end 102 ′ of the part 1 at the 6 o'clock position to the 3 o'clock position of the part 2, the 12 o'clock position of the part 3, and the 9 o'clock position of the part 4 to 6 o'clock of the part 5. It extends to the end 104 'of the position. The support member 110 has two portions 130 and 132 on both sides of the bent portion 134. The bending point 134 is arranged at a position of about 12 o'clock in the portion 3. The radii of curvature of the portions 120, 122 can be the same or different. The cross-sectional shape of the support member 105 is generally circular, but alternative embodiments may have one or more different cross-sectional shapes.

  [00101] FIG. 6C shows the crossover 106 and the first and second support members 105, 110 joined together at the ends. The first portions 120, 130 form a rounded frame 126. The angle β is formed by the portion of the end 102 that contacts the lumen wall and the surface that holds the frame 126 and is referred to as the take-off angle of the elongated member at the end 102. In one alternative, the angle β is formed by the portion of the lumen wall that contacts the end 102 and the surface that holds all or a portion of one or both of the portions 120, 130. In yet another alternative, the angle β is formed by the portion of the lumen wall that contacts the end 102 and the surface that holds all or a portion of the end 102 or all or a portion of the crossover 106. Another angle β is formed at one end 104 as described above, but in the description of end 104, as shown in FIGS. 7A-7C, the lumen wall in contact with end 104, portion 122, 132 and a rounded frame 128. The angle formed by the support members 126, 128 is generally in the range of 20 ° to 160 ° in some embodiments, and in some other embodiments is generally 45 °. To 120 °.

  [00102] FIG. 7A is a side view of portion 130 of FIG. 6B, FIG. 7B is a top view of FIG. 6B, and FIG. 7C is a side view of portion 132 of FIG. The angle β is generally in the range of 20 ° to 160 ° in some embodiments, and in some other embodiments, is generally in the range of 45 ° to 120 °. The angle α is formed by a portion of the portion 120, a portion of the portion 130, and the end 102. Alternatively, the angle α is formed by the end 102 and the tangent angle is formed by a portion of the portions 120, 130. Another angle α is formed on the end 104, as described above, but with respect to the description of the end 104, it is formed by the portion of the lumen wall that contacts the end 104 and the portions 122, 132. . The angle α is generally in the range of 40 ° to 170 ° in some embodiments and generally in the range of 70 ° to 140 ° in some other embodiments.

  [00103] FIG. 7D shows a top view of FIG. 6C. The angle σ is the angle between a portion of the portion 120 between the one side bend point 124 and the end 102 and a portion of the portion 130 between the opposite bend point 134 and the end 102 ′. Is defined as The angle σ is also between the portion of the portion 122 between the inflection point 124 on one side and the end 104 and the portion of the portion 132 between the inflection point 134 on the opposite side and the end 104 ′. Is defined as the angle. The angle σ defined by the portions 120, 130 is the same as the angle σ formed by the portions 122, 132, and can be larger or smaller. The angle σ is generally in the range of 10 ° to 180 ° in some embodiments and generally in the range of 45 ° to 160 ° in some other embodiments.

  [00104] FIG. 7D shows the end view of FIG. Is defined as the angle between the surface tangent to a portion of the portion 120 and the surface holding the end 102 parallel to the apparatus axis 121 as a whole. The angle θ may also be defined as the angle between the plane tangent to a portion of the portion 130 and the plane holding the end 102 parallel to the apparatus axis 121 as a whole. it can. The angle θ defined by the portion 120 is the same as the angle θ formed by the portion 130 and may be larger or smaller. Similarly, the angle θ is as described above, and the plane that is tangent to a portion of the portion 122 or 132, and similarly the plane that holds the end 102 that is generally parallel to the axis 121 of the device. Can be defined by using as the angle between. The angle θ is generally in the range of 5 ° to 70 ° in some embodiments and generally in the range of 20 ° to 55 ° in some other embodiments.

  [00105] FIGS. 7F and 7G are perspective views of one alternative embodiment of the apparatus shown in FIG. 6C. In the embodiment shown in FIG. 7F and FIG. 7G, the support member 110 intersects below and does not contact the support member 105 at the crossover 106. The gap “g” between the support members is also shown in FIG. 7G.

  [00106] FIG. 8A shows an elongated body 105 having a generally circular cross-section. But also, for example, a rectangular elongated body 105a (FIG. 8B), a rectangular elongated body with rounded edges (not shown), an elliptical elongated body 105b (FIG. 8C), and a flattened end Many other cross-sectional shapes are possible, such as a circular elongate body having an edge 105C (FIG. 8D). In some embodiments, the elongate body will have the same cross section along its length. In another embodiment, the elongate body will have different cross sections along its length. In another embodiment, the elongate body has a number of segments, and each of the segments has a cross-sectional shape. The cross-sectional shapes of the segments can be the same or different. The cross-sectional shape of the elongated member is a factor used to obtain a desired radial force along the elongated member. The material used to form the elongated body (ie, a biocompatible metal alloy, such as Nitinol) can be drawn to have a desired cross-sectional shape, or drawn in one cross-sectional shape, and then polished, lasered Processing can be performed using conventional techniques such as cutting and the like to obtain the desired cross-sectional shape.

  [00107] FIGS. 9A and 9B illustrate one embodiment of a material capture structure 115 that extends across a generally rounded frame 126 formed by a support member. FIG. 9A is a slight perspective view of the side view of the device. In this embodiment, the support member portions 120, 130 are generally located within a single plane that holds the rounded frame 126 (ie, in the side view of FIG. 9A, the portion 110 is visible, (Part 120 is not visible). FIG. 9B is a perspective view showing the material capture structure 115 extending between and attached to the rounded frame 126. In this embodiment, the capture structure 115 extends across the first portion 120, 130 and is attached to the portion 120, 130. In this embodiment, the material capture structure is a plurality of generally rectangular filter cells 119 formed by intersecting filaments 118. Other types of filter structures are described in more detail below and can also be supported by a support frame formed by the structural members. In some embodiments, such as FIGS. 9A and 9B, the angle β can also define the angle between the axis of the device and the surface holding the material capture structure.

  [00108] Support frame 126 and material capture structure 115 are not limited to planar configurations. For example, as shown in FIGS. 10A and 10B, non-planar and composite forms are possible. FIG. 10A is a side view of a non-planar structural support 110 ′ having another extension point 134 ′ between the extension point 134 and the end 102. The structural support 110 ′ has one or more radii of curvature between the end 102 and the crossover 106. In some embodiments, there are one or more radii of curvature between the end 102 and the inflection point 134 ′ and one or more radii of curvature between the inflection point 134 ′ and the inflection point 134. Can be. As a result, portion 130 'is a portion that will have different shapes, a number of different curvatures, and at least one inflection point. As shown in FIG. 10B, the support structure 105 ′ is non-planar with one or more different radii of curvature between the end 102 and the bending point 124. In some embodiments, there are one or more radii of curvature between end 102 and inflection point 124 ′ and one or more radii of curvature between inflection point 124 ′ and inflection point 124. You may make it do. As a result, the portion 120 'is a portion having a different shape, a number of different curvatures, and one or more inflection points. A similar non-planar form can be used at the end 104. The material capture structure 115 'is adapted to conform to the shape of the non-planar frame 126' to form a non-planar filter support structure.

  [00109] FIG. 11 shows a material capture structure 115 that remains in a generally planar arrangement between opposing portions of the support members 105,110. In addition to FIG. 10B above, other alternative non-planar capture structures are possible even when the support structure is generally planar. FIG. 12A is a perspective view showing a non-planar capture structure 245 within a generally planar support frame formed by the support members 105, 110. The capture structure 245 is formed of intersecting strands, fibers, filaments or other suitable elongate material 218 to form a filter cell 219. The capture structure 245 is slightly larger than the dimensions of the support frame, resulting in a filter structure that is deformed out of the plane formed by the support structure, as shown in FIG. 12B.

  [00110] The material capture structure 115 can be any of a number of different locations and orientations. FIG. 13A shows one embodiment of a filter of the present invention having two open loop support frames formed by support members 105, 110. The flow in lumen 10 is indicated by arrows. In this embodiment, the material capture structure 115 is disposed within an upstream open loop support structure. In contrast, the material capture structure may be placed in a downstream open loop support structure (FIG. 13B). In another alternative form, both upstream and downstream support frames hold material capture structures 115. FIG. 13C shows one embodiment where a material capture structure is disposed within each support loop within the device.

  [00111] There are embodiments of the filter device that include as many support frames with capture structures as support frames without capture structures (eg, FIGS. 13A, 13B). There are other embodiments having more support frames without capture structures than support frames with capture structures. FIG. 14 shows an embodiment 190 of a filter having more support frames without a capture structure than support frames having a capture structure. The filter device 190 has two support members 105, 110 that are arranged adjacent to each other to form a plurality of support frames that are provided for flow within the lumen 10. Alternatively, the plurality of support frames are arranged to support the material capture structure across the flow axis of the device 190 or lumen 10. The support members are coupled to each other at end 192 and have two inflection points before being coupled at end 194. The support members 105 and 110 cross each other at crossovers 106 and 196. Support frame 191 is between end 192 and crossover 106. Support frame 193 is between crossovers 106 and 196. Support frame 195 is between crossover 196 and end 194.

  [00112] The filter device 190 further includes a recoverable feature 140 at each end. The recoverable feature 140 has a curved portion 141 that terminates in a non-wound tip or ball 142. The retrievable feature 140 rises above the lumen wall and places all or part of the ball 142 and curved portion 141 into the lumen flow path and snares the device 190 for retrieval or repositioning. Simplify. Having a recoverable feature at each end of the device allows the device 190 to be recovered within the lumen 10 from an upstream or downstream approach to the device. Various features of embodiments of the recoverable features of the present invention are described in further detail below.

  [00113] FIG. 14A shows a filter 190 superimposed on a virtual cylinder having seven portions. The recoverable feature 140 is omitted for clarity. The first support member 105 extends about the axis of the device 121 and clockwise from the end 192 along the axis. The first support member 105 crosses part 2 at 9 o'clock, crosses part 3 and crossover 106 at 12 o'clock, crosses part 4 at 3 o'clock, and 6 o'clock Cross the part 5 and the crossover 196 at the position of 9, cross the part 6 at the 9 o'clock position, and cross the part 7 and the end 194 at the 12 o'clock position. The second support member 110 crosses part 2 at the 3 o'clock position, crosses part 3 and the crossover 106 at the 12 o'clock position, crosses part 4 at the 9 o'clock position, and 6 o'clock. Cross the part and the crossover 196 at the position 3, cross the part 6 at the 3 o'clock position, and cross the part 7 and the end 194 at the 12 o'clock position. FIG. 14B shows an alternative device embodiment 190a similar to device 190, except that all support frames formed by elongated members are used to support the material capture structure. In the illustrated embodiment, each of the frames 191, 193, 195 supports a material capture structure 115.

  [00114] FIG. 14C shows an alternative form of the filter 190. Filter device 190 b is similar to devices 190, 190 a and includes an additional support member 198 that extends along support member 105. In one embodiment, the additional support member 198 extends along the device axis 121 and is disposed between the first and second support members 105, 110 and has a first end 192. And a second end 194. In an exemplary embodiment, the third support member 198 starts at the end 192 of the portion 192 at the 6 o'clock position, traverses the portion 3 and the crossover 106 at the 12 o'clock position, Crosses part 5 and crossover 196 at the position of, and ends at part 7 of end 194 at the 12 o'clock position.

  [00115] FIG. 15 shows the symmetry planes found in some filter devices of the present invention. The filtration structure that would be supported by one or both of the support frames has been omitted for clarity. In one aspect, FIG. 15 illustrates one implementation of an intraluminal filter of the present invention having a support structure that is generally symmetrical about a plane 182 that is orthogonal to the flow direction of the filter or filter axis 121. Shown in configuration, this face 182 holds a crossover point 106 between the two components of the support structure 105, 110. In another aspect, FIG. 15 illustrates one implementation of an intraluminal filter of the present invention having a support structure that is generally symmetrical about a plane 184 parallel to the flow direction of the filter (ie, axis 121). The surface 184 is held at both ends of the support structures 102 and 104. It should be understood that some filter devices of the present invention may have one or both of the symmetrical properties described above. It should be understood that the symmetrical nature described above is also applicable to the structure of the material capture structure embodiment, either alone or installed in a filter.

  [00116] FIGS. 16A and 16B show the response of the filter device 200 in response to the thrombus material piece 99 contacting the material capture structure 115. FIG. The direction and movement of the thrombus material 99 within the lumen 10 is indicated by arrows. The filter device 200 is similar to the embodiment described above with respect to FIGS. 6A-7G, with a recoverable feature 240 added to the ends 102,104. The recoverable feature 240 includes a curved portion having a number of curved portions 141 that end at a non-wounding end 242. The multiple curved portions 141 are preferably configured to be folded around a recoverable device (ie, the snare of FIGS. 71A, 71B) to facilitate capture of the device 100 during recovery. In this exemplary embodiment, the multiple curved portions are generally sinusoidal in shape and the end 242 is similar in shape to a ball or rounded tip.

  [00117] When the embolus is captured, the fluid flow force acting on the clot material 99 is transmitted from the capture structure 115 to the support frame 126 that secures the capture structure 115. A force acting on the support frame 126 and on one side the support members 105, 110 pushes the end 104 into the lumen wall. This operation effectively fixes the second support frame 128. The angle β associated with the support frame 126 by the force acting on the support frame 126 further increases the wedge-like pushing of the support frame 126 into the lumen wall.

  [00118] FIGS. 17, 18 and 19 illustrate various filter device embodiments having different sized support structures and not in contact with the lumen wall. FIG. 17 shows a perspective view of a filter device 300 according to one embodiment of the present invention. In this embodiment, elongate members 305, 310 are joined at end portions 302, 304, frame 309 from end 302, portions 301, 303, crossover 306, frame 311 from end 304, portion 307 , 308 and crossover 306. Frame 309 supports another embodiment of a material trap according to the present invention. The illustrated material capture structure 312 includes a plurality of strands 313 coupled 314 to form a plurality of filter cells 315. The strands 313 can be combined using the process described below (eg, FIGS. 53A-53D) or formed by extruding a filter cell 315 of a desired shape and size from a material (eg, FIG. 56).

  [00119] FIG. 17 illustrates a so-called capacitor design because the elongated members forming the frame 311 are configured to expand and contract the size and shape of the frame 311 in response to changes in the frame 309. This design feature allows one embodiment of the present invention to accommodate a wider range of dimensional and diameter changes. FIG. 18 illustrates one embodiment of a filter device 300 that includes a capture structure 350 having filter cells 354 formed by intersecting strands 352. FIG. 18 illustrates how the inward movement of the frame 309 (shown by arrows) corresponds to the outward movement of the frame 308 (shown by arrows).

[00120] FIG. 19 shows an alternative filter device in which the second frame is not closed. The filter device 340 includes support members 341, 343 that form a rounded support frame 344 that supports the material capture device 115. Support members 341, 343 extend a significant distance beyond crossover 342, but are not joined to form the other end. A portion 346 of the support member 343 is shown extending beyond the crossover 342. The support members 341, 343 can extend a considerable distance along the axis of the device after the crossover 342 and can follow the same or different shape as the support members in the frame 309. The support member extends along a device similar to the two loop embodiment described above, but ends just before being joined at the second end (eg, FIG. 87).
[00121] The ends of the filter device of the present invention can be formed in a number of ways. Portions of the support structures 105, 110 can be wound 180 together (FIG. 20). In the illustrated embodiment, the wound portion 180 is used to form the end 102. In another alternative, the filtration device is formed from a single support member 105 that loops around itself. In the exemplary embodiment of FIG. 21, the support member 105 is formed on the loop 181 to form the end 102. As an alternative to loop 181, the loop can hold a plurality of undulations (ie, loop 181 a in FIG. 22) or be in the shape of a recoverable feature or other component of the filter device. Can be formed. In yet another alternative, a cover is used to clamp structural members together, join, or otherwise join. In the example of FIG. 23, the members 105 and 110 are coupled together using a generally cylindrical cover 183. The cover 183 can secure the support members to each other using any conventional joining method, such as adhesives, welding, crimping, and the like. An alternative tapered cover 185 is shown in the embodiment of FIG. The tapered cover 185 has a cylindrical shape and a tapered end 186. A tapered end 186 is around the end having a tapered cover 185 and facilitates device deployment and retrieval. In one embodiment, the cover 185 is made of the same material as the structural member and / or the recoverable feature.

  [00122] Some filter device embodiments of the present invention provide one or more recoverable features to help recapture and partially or fully recover the deployed filter device. Can be included. The recoverable features can be placed at any of a number of locations on the device, depending on the particular filter device design. In one embodiment, the recoverable device is not only arranged to facilitate device recovery, but also in such a way that pulling the recoverable device actually facilitates removal of the device. Attached to the device. In one embodiment, the structural member is pulled away from the lumen wall when the retrievable device is pulled. These and other features and collaborative operations of the retrievable features during deployment and recapture are described with respect to FIGS. 72A-73D.

  [00123] Several alternative embodiments of the recoverable device of the present invention are shown in FIGS. 25-27C. FIG. 25 shows a recoverable device 240 having a single curved portion 241 formed at one end. FIG. 26 shows a recoverable device 240 having a curved portion 244 having a radius of curvature that is sharper than the curved portion 241 of FIG. FIG. 27A shows a recoverable feature 140 that includes a curved portion 141 having a non-wound end 142. In an exemplary embodiment, the non-wounding end 142 is a ball that is added to the end of the curved portion 141 or on the end of the member used to form the feature 140. Can be formed. The ball 142 can be formed by laser processing the end of the curved portion 141 and melting the end into the ball. FIG. 27B shows a recoverable feature having a plurality of curved portions 241. In one embodiment, the curved portion 241 has a sinusoidal shape as a whole. In another embodiment, the curved portion 241 is configured to fold when pulled by a recoverable device such as a snare (ie, FIGS. 71A, 71B). FIG. 27C shows a recoverable feature 240 having a plurality of curved portions 241 and a ball 142 formed on the end. In additional embodiments, the recoverable features of the present invention can include markers or other features that help improve the visibility or image quality of the filter device using medical imaging. . In the exemplary embodiment of FIG. 27C, a radiopaque marker 248 is placed on the curved portion 241. Marker 248 can be made of any suitable material, such as platinum, tantalum or gold.

  [00124] A cover disposed around the ends may also be used to couple the recoverable features at one end or to the two support members. The cover 183 can be used to couple the recoverable feature 240 to the support member 105 (FIG. 28A). In this exemplary embodiment, the support structure 105 and the recoverable feature 240 are separate parts. The cover 183 can also be used to couple the two members 110105 together with the recoverable feature 140 (FIG. 28B). In another alternative embodiment, the recoverable feature is formed from a support member that is coupled to other support members. In the exemplary embodiment of FIG. 28C, the support member 105 extends through the tapered cover 185 and is used to form a recoverable feature 240. A tapered cover 185 is used to join the first support member and the second support member 105, 110. In one alternative to the embodiment shown in FIG. 28C, the diameter of the support member 105 is greater than the diameter of the recoverable feature 240. In another embodiment, the recoverable feature 240 has a diameter that is smaller than the diameter of the support member 105 and is formed by machining the end of the support member to a smaller diameter, and then shaped and recovered. A possible feature 240 is formed. In another embodiment, the ball 242 or other non-wounding end is formed at the end of the recoverable feature.

[00125] FIG. 29 shows a partial side view of the filter device within lumen 10. FIG. This figure shows the angle τ of the recoverable feature formed by the recoverable feature and the inner wall of the lumen. The recoverable feature angle τ is useful when adjusting the height and orientation of the recoverable curve 214 and ball 242 in the lumen to improve the recoverability of the device. Overall, recoverability improves as the recoverable features move closer to the device axis 121 (ie, also towards the center of the lumen axis). Additional curves may be added to the support members 110, 105 as necessary to provide the desired range of recoverable feature angles. In one embodiment, τ is in the range of −20 ° to 90 °. In another embodiment, τ is in the range of 0 ° to 30 °.
Attaching the material capture structure and other filtration structures to the support structure [00126] A number of different techniques can be used to attach the material capture structure to the support member. For clarity, the material capture structure is omitted in the following drawings, but could be secured as appropriate using lines 351 or loops. FIG. 30 shows a line 351 having a number of rotating parts 353 around the support member 105. Line 351 is secured to itself using clip 351a. FIG. 31 shows a line 351 that secures a loop 353a that has a number of rotating parts 353 around the support member 105 and that can be used to connect or otherwise secure the material capture structure. . The line 351 can also be bonded (355) to the support 105 (FIG. 32). In another alternative embodiment, these holes are used to secure the material capture structure while using holes 356 formed in the support member or securing more lines 351. The In an alternative to linearly arranging the holes 356, FIG. 36 illustrates providing the holes 356 in a number of different orientations to help secure the material trap to the support structure 105. FIG. Alternatively, line 351 can be glued (355) into hole 356 (FIG. 34A and cross-sectional view 34B).

  [00127] In other alternative embodiments, the holes 356 are used to secure the wire 351 and provide a cavity for incorporating another material into the support structure 105. Other materials that can be incorporated into the support structure 105 include, for example, drugs or radiopaque materials. The use of radiopaque markers is useful, for example, when the support structure is formed of a low image visual material, such as a shape memory polymer or a biodegradable polymer. FIG. 34C shows one embodiment where one hole 356 is used to secure line 351 and the other hole is filled with material or compound 357. In another alternative, some or all of the holes 356 can be filled with another material, as shown in FIG. In yet another alternative, the hole 356 is filled with a small ridge 358 that can be used to secure the device to the lumen wall. In the exemplary embodiment of FIG. 37, hook-shaped portion 358 is long enough to break the surface of the inner wall of the lumen but not puncture the lumen wall. Although each of the above has been described with respect to support member 105, it should be understood that these same techniques can be applied to support member 110 or other structures used to support the material capture structure. . Additional alternative embodiments of hooks, hooks or other securing devices or elements are described below with respect to FIGS. 88-126D.

  [00128] It should be understood that the support structure is not limited to a single member structure. FIG. 38A shows an alternative hooked support member 105 ′. The hooked support member 105 ′ is formed by four strands a, b, c, and d. FIG. 38B shows another alternative hooked support member 105 ″. The hooked support member 105 ″ is formed by three strands a, b, and c. FIG. 38B shows a state in which the line 351 is fixed using the hook-shaped structure. As can be appreciated in this embodiment, the material capture structure (not shown) is secured to at least one strand within the barbed structure 105 ″ by using the wire 351.

  [00129] FIGS. 39 and 40 illustrate additional alternative techniques for securing the filter support structure to the support member. As shown in FIG. 39, a technique for securing a wire 351 to a support frame 105 that secures a material capture structure using material 481 wound around the support frame 105 is shown. In this way, the material capture structure (not shown but attached to the line 351) is attached to the material 481 that at least partially covers the first support structure 105. Line 351 passes between material 481 and support structure 105 when material 481 and wrap 483 are formed along support structure 105. Line 351 is omitted in the embodiment shown in FIG. 40 because material 481 forms a wrap 483 and is used to secure a material capture structure (not shown). It is. In one embodiment, material 481 forms a coating that minimizes tissue ingrowth on at least a portion of the support structure. Alternatively, a filtration structure (not shown) is attached to the support structure 105 using a coating 481 that minimizes tissue ingrowth.

  [00130] FIGS. 41, 42 and 43 relate to securing a material capture structure to a lumen disposed about a support member. FIG. 41 shows a lumen 402 cut into segments 402a, 402b, 402c separated by a distance “d”. Line 351 is mounted around the support member and is within the distance “d” between adjacent segments. The segments can be separated or remain pressed against each other and the gap “d” can be shortened or eliminated. Unlike the segment of FIG. 41, the lumen 402 of FIG. 42 provides a notch 403 for securing the line 351. FIG. 43 shows a lumen 405 having a feature 408 that prevents tissue ingrowth extending away from the support member 105. As can be seen in the cross-sectional view 406, the blocking feature 408 has a different cross-sectional shape than the support member 105. Further, in some embodiments, lumen 405 is selected from a material that minimizes appropriate tissue ingrowth to act similarly to a coating that minimizes tissue ingrowth on the support structure. . In other embodiments, the cross-sectional shape 406 is configured to prevent tissue growth on a coating that minimizes tissue ingrowth.

  [00131] FIGS. 44 and 45 illustrate an embodiment of a filter device that utilizes a dual lumen structure. The dual lumen structure 420 includes a lumen 422 and a lumen 424 and has a generally tear-shaped cross-sectional area. In this exemplary embodiment, support structure 105 is disposed within lumen 422 and uses second lumen 424 to hold line 351 and a material capture device (not shown). ). In an exemplary embodiment, the lumen structure 420 is notched to form a number of segments 420a, 420b, 420c, 420d within the lumen 424. The connection formed by segments 420a-420d is used to secure line 351 as needed. FIG. 45 shows one alternative configuration for the luminal structure 420. In this alternative form, the release line 430 extends through the notched lumen 424. Line 351 extends around release line 430 and thus secures the material capture structure (not shown). Since line 351 is connected using a release line, removing the release line from lumen 424 releases the material capture structure secured using line 351 from the support structure and the lumen. Allow to be removed from. The configuration as shown in FIG. 45 provides a filtration structure that is releasably attached to an open loop (ie, an open loop frame formed by a support structure). The embodiment shown in FIG. 45 provides a release line 430 disposed along an open loop (formed by member 105), and the filtration structure (not shown) uses a release line. Attached to the open loop.

  [00132] In another embodiment, the filter device of the present invention is configured to be a coated intraluminal filter. In addition to coating all or part of the support structure or filter element of the device, the coating on the support member can also be used to secure the filtration structure to the support structure. In one embodiment, the coated intraluminal filter has a support structure, a filtration structure attached to the support structure, and a coating on at least a portion of the support structure. In one aspect, the coated support structure can form a rounded support frame and an open loop or other structure to support the filtration structure described herein. In one embodiment, the coating on at least a portion of the support structure is used to secure a plurality of loops (ie, a flexible form or a rigid form) to the support structure. A plurality of loops are then used to secure within an intraluminal filter coated with a filtration structure, such as a material capture structure. In one embodiment, the coating is a coating that minimizes tissue ingrowth.

  [00133] It should be understood that the filtration structure can also be attached to the support structure using a coating that minimizes tissue ingrowth. In some embodiments, the coating that minimizes tissue ingrowth can be wrapped around the support structure, or alternatively, the coating can take the form of a tube. Good. If a tube is used, the tube may be a continuous tube or consist of multiple tube segments. The tube segments can be in contact or separated. The tube can have the same or different cross-sectional shape as the support member. In another embodiment, the coating that minimizes tissue ingrowth is in the shape of a tube and the support structure is within the tube.

  [00134] In some other embodiments, an adhesive material is provided between the covering and the support structure that minimizes tissue ingrowth. The adhesive material can be wrapped around the support structure or can take the form of a tube. If a tube is used, the tube can be a continuous tube or consist of multiple tube segments. The tube segments can be in contact or separated. The tube of adhesive material can have the same or different cross-sectional shape as the support member or the coating around the adhesive material. In one embodiment, the adhesive material is in the form of a tube having a support member that extends through the lumen of the tube of adhesive material. In one embodiment, a plurality of loops (ie, a flexible form or a rigid form) are used to form a loop between the adhesive material around the support member and the coating around the adhesive material. The tube is fixed to the support structure by sandwiching the tube. In one embodiment, the adhesive material has a lower reflow temperature than the coating around the adhesive material. In this embodiment, the tube used to form the loop is secured, at least in part, by reflowing the adhesive material and secured between the coating around the adhesive material and the support structure. . In another alternative, the coating around the adhesive material is a shrink-fit coating that shrinks around the adhesive structure and the support member during or after the adhesive material is reflowed. In any of the alternatives described above, multiple loops can be used to secure a filtration structure, such as a material capture structure, for example, within a coated endoluminal filter.

  [00135] Some embodiments of the coated intraluminal filter are rounded, eg, recoverable features on the support structure, recoverable features on each end of the support structure, Some of the other features described herein, such as a support structure having two elongated bodies joined together to form a frame and a support structure having two helical elongated bodies, or Includes everything. In addition, some coated endoluminal filters have a generally symmetrical support structure about a plane that is orthogonal to the filter flow direction and that retains the crossover point. In another alternative coated endoluminal filter embodiment, the support structure of the coated endoluminal filter is parallel to the flow direction of the filter and around a plane that holds both ends of the support structure. It is symmetrical as a whole.

  [00136] FIGS. 46-51B illustrate some features of an embodiment of a coated endoluminal filter. These figures are not to scale and have exaggerated dimensions to clarify specific details. FIG. 46 shows a number of covering segments 450 disposed around the support member 105. One or more tubes 451 extend between the segment 450 and the support member 105 and form a plurality of loops 453. In one embodiment, tube 451 is a single continuous tube. When formed, the segment 450 shrinks the diameter of the segment around the tube 451 and the support member 105, thereby suitable processing to secure the tube 451 and loop 453 to the support structure (FIG. 47). Receive. The segment 450 is fixed around the support member 105 as shown in the end view of FIG. 51A. The segments 450 in the embodiment shown in FIG. 47 are separated. In other embodiments, the segments 450 can be in contact or have a different spacing than that shown in FIG. The dimensions of the various components shown in FIGS. 46, 47 and 51A are exaggerated to show details. The dimensions of one specific embodiment are as follows. That is, the support member 105 is a NiTi wire having an outer diameter in the range of 0.279 mm (0.011 inch) to 0.381 mm (0.015 inch), and the segment 450 is 0.457 mm (0 0.18 inches) and a length of 5.08 mm (0.2 inches) cut from a PTFE thermal shrink tube having a wall thickness of 0.0508 mm (0.002 inches). 0.076 mm (0.003 inch) outer diameter monofilament ePTFE and loop 453 has a nominal diameter in the range of about 2.54 (0.1) to about 10.2 mm (0.4 inch). have.

  [00137] FIGS. 48, 49 and 51B show an adhesive material 456 around the support member 105 and a number of segments 455 around the adhesive material 456. FIG. One or more tubes 451 extend between the segment 455 and the adhesive material 456 and form a plurality of loops 453. In one embodiment, tube 451 is a single continuous tube. When formed, the adhesive material 456 and / or segment 450 secures the tube 451 between the adhesive material 456 and the covering 455, thereby connecting the tube 451 and the loop 453 to the support structure (FIG. 49). To receive a suitable processing method. The covering segment 450 and the adhesive material 456 are fixed around the support member 105 as shown in the end view of FIG. 51B. The segments 455 in the embodiment shown in FIG. 48 are separated by a distance “d”. In other embodiments, the segments 455 may be brought into contact after processing (FIG. 49) or spaced apart from those shown in FIG. In one preferred embodiment, the separation between segments 455 is eliminated by a portion of adhesive material 456 that flows between adjacent segments 455 and secures adjacent segments. The dimensions of the various components shown in FIGS. 48, 49 and 51B are exaggerated to show details. The dimensions of one specific embodiment are as follows. That is, the support member 105 is a NiTi wire having an outer diameter of 0.279 mm (0.011 inch) to 0.406 mm (0.016 inch), and the segment 455 is 0.559 mm (0.022 inch). A length of 7.62 mm (0.3 inch) cut from a PTFE thermal shrink tube having a wall thickness and a thickness of 0.0508 mm (0.002 inch), the adhesive material is 0.457 mm (0.018 mm). Inch FEP thermal shrink tube having a pre-shrink outer diameter of 0.0254 mm (0.001 inch), and tube 451 is a PET of 0.0508 mm (0.002 inch) outer diameter. The monofilament, the loop 453 has a nominal diameter in the range of about 2.54 (0.1) to about 10.2 mm (0.4 inches). It should be understood that the segments 450, 455 and the adhesive material 456 can be formed of, for example, ePTFE, PTFE, PET, PVDF, PFA, FEP, and other suitable polymers. Further, the strand, wire, fiber, and filament embodiments described herein may be formed from ePTFE, PTFE, PET, PVDF, PFA, FEP, and other suitable polymers.

  [00138] FIG. 50 illustrates the use of a continuous flexible wire 452 that travels through a continuous covering segment 450 and forms a loop 454. FIG. The loops 454 are disposed along the length of the coating 450 at regular intervals. The continuous covering segment 450 is a support member using a PTFE thermal shrink tube having a pre-shrinked diameter of 0.457 mm (0.018 inch) and a wall thickness of 0.0508 mm (0.002 inch). Uniform length for 105. Line 452 is a monofilament ePTFE having an outer diameter of 0.0762 mm (0.003 inches) and loop 454 is a nominal diameter of about 2.54 (0.1) to about 10.2 mm (0.4 inches). have.

  [00139] FIGS. 52A-53D illustrate an alternative technique for forming a filtration structure and / or attaching the filtration structure to a support structure. FIG. 52A shows one embodiment of the support frame 126 formed by the support members 105, 110 between the end 102 and the crossover 106, as described above. Loops 453/454 are formed using lines 451/452 as described above with respect to FIGS. 46-51B. Thereafter, filament 461 is suitably attached to wire 451/452 by connection, welding, bonding or by incorporating filament 461 during the processing steps described with respect to FIGS. 46-51B (462). The filaments then cross frame 126 and intersect around loops 453/454. In this embodiment, the embroidery pattern between the loops traverses a line extending between end 102 and crossover 106. The overall pattern is that the filament extends across frame 126 and around one right loop (1) and back across frame 126 (2) and around left loop 453/454 (3). . The embroidery process continues as shown in FIGS. 52B and 52C. When complete, the embroidery process creates a filtration structure 465 from one or more filaments secured to loops 451/452 secured to support members 105/110. The filaments in the filtration structure 465 can be tensioned between the loops 451/452 or have some sagging (as shown in FIG. 52D). The filament 461 or other material used to form the material capture structure can be coated with a drug (coating 466 in FIG. 58). The drug can be any of a variety of compounds, drugs, and the like that are useful in the methods performed using the various filtration device embodiments of the present invention or by their action. The drug coating 466 can include a drug useful for preventing or reducing thrombus formation on the filtration structure and chemically dissolving debris and the like collected in the filtration structure.

  [00140] FIG. 53A illustrates one embodiment of a support frame 126 formed by the support members 105, 110 between the end 102 and the crossover 106, as described above. Loops 453/454 are formed using lines 451/452 as described above with respect to FIGS. 46-51B. Filament 461 is then suitably connected to line 451/452 by connecting, bonding or incorporating filament 461 during the processing steps described with respect to FIGS. 46-51B (462). The filament 461 was then embroidered as described above with respect to FIG. 52A around the loop 453/454. However, in this embodiment, the embroidery pattern between the loops remains generally parallel to the line extending between the end 102 and the crossover 106. When completed, the embroidery process can be fixed to one or more loops 451/452 extending parallel to the line between the end 102 and the crossover 106 and secured to the support member 105/110. A filtration structure is created from the filament 461. This filtration structure (FIG. 53A) can be used in the filter device of the present invention. Further, the filtration structure of FIG. 53A (similarly, the structure of FIG. 52D) is further processed to bond adjacent to the filament 461 (468) to form a filter cell 469 as part of the filtration structure 470. To do. The process used to bond (468) adjacent to the filament 461 can include any conventional bonding technique, such as connecting, welding, bonding, bonding, and the like. Further, tube segments (ie, segments 450, 455, 456 described above) can be used to join (468) portions of adjacent filaments 461. In one particular embodiment, the filament 461 is a FEP heat shrink tube having a pre-shrink outer diameter of 0.203 mm (0.008 inches) and a wall thickness of 0.0254 mm (0.001 inches). (468) ePTFE monofilament having an outer diameter of 0.0762 mm (0.003 inch) bonded using strips. The filtration structure 470 can be tensioned or have some degree of sagging between the loops 451/452 (as shown by the filtration structure of FIG. 52D). The filter cell 469 can be formed in a number of dimensions and shapes, as will be described in more detail below.

[00141] Alternatively, the filtration structure of FIGS. 53A and 52D may incorporate an additional loop 491 formed by forming the filament 461 into a loop, as shown in FIG. 57A. it can.
Alternative Filtration and / or Material Capture Structure [00142] In some embodiments, the material capture structure holds multiple filter cells. The filter cell can be formed in a number of different ways and can have a number of different shapes and dimensions. The shape, size and number of filter cells in a particular filter can be selected based on the use of the particular filter. For example, the filter device of the present invention, which is configured to protect the end, is formed from several tens of μm to several hundreds of μm to 5 mm formed by selecting a filter material having a pore size (FIGS. 63A and 63B) suitable for a desired filtration level. It can have the following filter cell dimensions. In other applications, the filter cell may be superposed (bonded or crossed without bonding) to form a cell that filters out debris in lumens with dimensions greater than 2 mm. Can be formed. As described herein, various other filter dimensions and filtration capacities are possible.

  [00143] Cross-type filaments (FIG. 54C) can be used to form diamond shaped filter cells (FIG. 54A) and rectangular shaped filter cells (FIGS. 54B, 2A, 9B). Numerous strand patterns can be used, such as the three strands 461a, 461b, 461c array shown in FIG. 57B. Crossed filaments can be tied, connected or otherwise joined (468) (FIGS. 55A and 55E). Crossed filaments can be the same or different filter cell shapes, such as an elongated oval shape in FIG. 55C, one or more combined diamonds in FIG. 55B, and an array of combined polygons as in FIG. 55D. Can be formed. Cells can be formed using techniques such as those described above in FIGS. 52A-53D. In one embodiment, the filter cell is defined by at least three crossed filaments 461. Filament element 461 is biocompatible and can be formed from any of a variety of acceptable materials for filtering debris. For example, the filaments, lines and strands described herein can be in the form of multifilament sutures, monofilament sutures, ribbons, polymer strands, metal strands or composite strands. Further, the filaments, wires and strands described herein are drawn polytetrafluoroethylene (ePTFE), polytetrafluoroethylene (PTFE), poly (ethylene terephthalate) (PET), polyvinylidene fluoride (PVDF), tetra It can be formed of fluoroethylene-co-hexafluoropropylene (FEP), or poly (fluoroalkoxy) (PFA), other suitable medical grade polymers, other biocompatible polymers, and the like.

  [00144] The joined polygons can have any of the shapes shown in FIGS. 60A-60F. The filter cell can be any shape, such as a circle (FIG. 60A), a polygon (FIG. 60B), an ellipse (FIG. 60C), a triangle (FIG. 60D), a trapezoid or a truncated cone (FIG. 60E). Can have one, one or more, or a combination thereof.

  [00145] Additionally, the material capture structure can have a filter cell formed by extruding material into the material capture structure. FIG. 56 shows an exemplary filtration structure 312 in which material is extruded into strands 313 that are joined (314) and spaced apart to form one or more filter cells 315. In one embodiment, the strands are extruded from a polypropylene material to form a diamond shaped filter cell having a height of about 4 mm and a width of 3 mm.

  [00146] FIGS. 59A-63B illustrate several different filtration structure configurations. In order to simplify the drawing, the filtering material is shown mounted on a circular frame 501. Circular frame 501 may represent any of the various open, rounded or other support frames described herein. FIG. 59A shows a frame pattern similar to FIG. 52D. FIG. 59B adds an additional transverse filament 461 at an angle to the filament 461. FIG. 59C shows a plurality of filaments 461a extending upward from the bottom 501a of the frame around the central filament 461c and a plurality of filaments 461b extending downward from the top 501b of the frame around the central filament 461c. In this exemplary embodiment, the filaments 461a and 461b are arranged symmetrically around the central filament 461c. Other asymmetrical forms are possible. One or more central filaments 461c can be used to form polygonal filter cells of a variety of different sizes and shapes (eg, FIG. 59E).

  [00147] The filaments can be arranged using a variety of radial patterns. For example, the multiple filaments 461 can form a common point 509 outside the edge of the frame 501. In some embodiments, the common point is at the center of the frame 501 (FIG. 59D), and in other embodiments, the common point 509 is at a different non-centered position. A sector formed by multiple filaments (FIG. 59D) can be further divided into multiple filter cell segments by wrapping the filaments 461a around and across the segment filaments 461b. As shown in FIG. 59G, unlike the single strand that is helically cut from point 509, the segmented filter cell of FIG. 59F is obtained by attaching a single filament 461a to a segment filament 461b. It is formed.

  [00148] FIGS. 61A-C and 62 illustrate the use of a sheet of material 520 to form a filter structure. The material 520 can have any of a variety of shapes formed using any suitable method, such as a method of drilling, puncturing, laser cutting, and the like. FIG. 61A shows a circular pattern 521 formed in the material 520. FIG. 61B shows a rectangular pattern 523 formed in the material 520. FIG. 61C shows a complex pattern 522 cut into the material 522. It should be understood that the material 520 can be placed in the frame 501 without any pattern (FIG. 62). The example embodiment of FIG. 62 is useful for occluding flow within a lumen. Materials 520 suitable for occlusion purposes include, for example, wool, silk, polymer sheets, other materials suitable for preventing blood flow in the lumen when stretched over the lumen, and the like. Further, the filter material 520 can be a porous material having pores 530 (FIG. 63A). The material 520 can be selected based on the average size of the individual pores 530 (FIG. 63B) depending on the method or use of the filter device. For example, material 520 can be any of the porous materials used in existing end protection and embolism protection devices. In general, a variety of pore 530 dimensions are available and can range from 0.254 mm (0.010 inches) to 7.62 mm (0.3 inches). Other pore dimensions are available depending on the material 520 selected.

  [00149] FIGS. 64-65F illustrate the use of a mesh or other web structure within the filtration device. The various mesh structure embodiments described herein are used as material capture structures within the filter device embodiments of the present invention. Each of these alternatives is shown in a support structure similar to device 100 in FIG. 2A and other figures. When deployed within the lumen 10, the material capture structure 560 has a defined shape, such as a cone with a distinct apex 565 (FIG. 64A). In this embodiment, the mesh structure is long enough to contact the sidewall of lumen 10 when deployed within lumen 10. Alternatively, the apex 565 can be attached to the end 104 to keep the mesh 560 in the lumen flow path out of contact with the lumen sidewall (FIG. 64B). The mesh 565 can also have a rounded apex 565 (FIG. 65A) or a cutting cone (flat bottom) (FIG. 65D). Alternatively, the mesh 560 may have individual vertices 565 so as not to contact the lumen sidewall when deployed (FIG. 65B). The short mesh can also have rounded vertices 565 (FIG. 65B), flat vertices (FIG. 65E), or acute vertices (FIG. 65C). In addition, the mesh 560 can have a composite vertex 565 (FIG. 65F).

[00150] FIGS. 66 and 67 illustrate a method for combining the various different features described above. For example, FIG. 66 shows a multi-supported frame device 480 having features that can only be recovered at one end and an open frame (ie, no filter structure). FIG. 67 shows an alternative multi-support frame apparatus having different recoverable features at each end and filter structures at each of the support structures, each of the filter structures having a different filter capability. 485 is shown. The structures, elements, dimensions, and other details of the various filter device embodiments described herein can be combined in a number of different ways to form a variety of alternative filter device embodiments. It should be understood that it can be created.
Filtration Device Delivery, Recovery, and Repositioning [00151] FIG. 68A illustrates one embodiment of the filter device 100 of the present invention loaded into an intravascular delivery sheath 705. FIG. Apparatus 100 is disclosed, for example, with respect to FIG. 16A and described above. Using conventional endoluminal and minimally invasive surgical techniques, the device is loaded into the proximal end of sheath 705 before or after advancement of sheath 705 into the vessel, and then conventional A push rod can be used to advance through the sheath. The push rod is used to advance device 100 through the lumen of the delivery sheath and to fix the position of the device (relative to sheath 705) for device deployment. In one preferred technique, the device is already loaded into the proximal end of the delivery sheath that has been advanced to the desired position within the vessel (FIG. 68B). The device 100 can be preloaded into a short segment of polymerization tubing or other suitable cartridge, which allows the device 100 to be more easily advanced through the hemostasis valve.

  [00152] When used with a flexible infeed sheath 705, the preformed shape of the device 100 deforms the sheath to conform to the shape of the device (FIGS. 69A, 69B). Thus, the flexible, flexible sheath 705 takes the curvature of the stored device. Deformation of the delivery sheath 705 stabilizes the position of the sheath 705 within the vessel and facilitates accurate deployment of the device 100 at the intended delivery location. On the contrary, the non-flexible delivery sheath 705 (i.e., the sheath is not deformed so as to conform to the preformed shape of the device 100), even when the apparatus 100 is stored therein as a whole a cylindrical Appearance is maintained (FIG. 69C). Regardless of the type of sheath used, device delivery uses a push rod on the proximal side of the device to fix the position of the device within the sheath 705 and then pulls the sheath 705 proximally. It is realized by. As device 100 exits the distal end of sheath 705, the device takes the form of a preformed device (FIG. 69D).

  [00153] The symmetrical device geometry (see, eg, the devices of FIGS. 15 and 16A) facilitates deployment and retrieval of the device at multiple access points within the vascular tissue. Device 100 is shown positioned within the vascular tissue within the inferior vena cava 11 directly below the renal vein 13 (FIG. 70). The thigh access path (solid line) and the access path (virtual line) of the neck 14 are shown. The thigh access path (solid line) and the neck access path are used for device deployment, repositioning and retrieval, respectively. Alternatively, the vena cava can be accessed through a branch or anterior elbow access point for device deployment, repositioning and retrieval.

  [00154] Most preferably, device retrieval is performed by capturing in the lumen using one of the recoverable features described herein (ie, FIGS. 27A-E). The recoverable features described herein are designed to work well using commercially available snares, two of which are shown in FIGS. 71A and 71B. A single loop gooseneck snare 712 is shown in FIG. 71 within the retrieval sheath 710. Multiple loop En snares 714 are shown in FIG. 71B inside the recovery sheath 710. These conventional snares are controlled by the surgeon using a flexible integral wire.

  [00155] The procedure for recapturing and removing the device from the body cavity (in this case, the vena cava 11) is shown in FIGS. 72A-C. In these drawings, a solid line indicates recovery from the thigh, and a virtual line indicates recovery from the neck (for example, FIG. 70). The folded snare is advanced through the infeed sheath to the vicinity of the recoverable feature 240 (FIG. 72A). When it becomes required position, the snare 712 is exposed, take the form of a loop which extends a previously defined formed in a loop shape at the recoverable feature 240 on as shown from both ends of FIG. 72B.

  [00156] Next, the snare device 100 is retracted into the sheath 710, or alternatively and more preferably, the delivery sheath 710 ensures that the snare 712 is secured when the sheath 710 is advanced over the device 100. The device 100 is moved forward over the device 100 while maintaining proper control. Advancement of the retrieval sheath 710 over the device 100 facilitates the non-wound removal of the device 100 from any tissue that has grown in or around the device 100. A recoverable action that tends to fold the device radially inward (FIG. 72D) facilitates removal from any tissue layer formed on the device. The filtration device is recovered by pulling the flexible recoverable feature attached to the filtration device. Furthermore, pulling a portion of the filter structure (ie, the recoverable feature) will remove the opposing helical element from the lumen wall.

  [00157] As the device is retracted into the sheath 710, the preformed shape of the device pushes the support member away from the lumen wall, which helps remove the device non-wounding.

  [00158] The flexible recoverable element 240 takes a folded configuration when retracted into the recovery sheath, as shown in FIGS. 72C and 72E. The recoverable feature 240 at the other end of the device takes a straight configuration when retracted into the recovery sheath (FIG. 72F). An additional embodiment in which a single curved recoverable feature 140 (FIG. 27A) is retracted into the delivery sheath 710 is illustrated in FIG. 73A. The distal recoverable (relative to snare) feature takes the straight form of FIG. 73C from the curved form of FIG. 73B when fully retracted into the sheath of FIG. 73D.

  [00159] Further, repositioning the filter 100 from one lumen position to another is shown in FIGS. 74A-74D. Due to the non-wounding design of the filter device of the present invention, the repositioning of the filter device 100 either completely recaptures the device 100 within the retrieval sheath 710 (FIG. 74C) or only partially recaptures (FIG. 74B). ) Can be executed. The non-wounding design of the device 100 allows the device to be easily secured at one end (FIG. 74B) and also pulled to the desired location along the lumen wall and then released. Delivery sheath and retrieval sheath is displayed with the same reference numbers, it is a filter device of the present invention, removed from the deployed and vascular tissue by using the sheath is approximately the same size in vascular tissue Because it can be done. Thus, the device of the present invention can be deployed into vascular tissue from a delivery sheath having a first diameter. The device can then be retracted from the vascular tissue using a retrieval sheath having a second diameter that is 2 Fr greater than the first diameter (1 Fr = 0.013 inches = 1/3 mm). Alternatively, the second diameter is 1 Fr greater than the first diameter, or alternatively, the first diameter is approximately the same as the second diameter.

[00160] When fully recovered, the device is fully retracted into the recovery sheath (Fig. 74A), and the sheath is repositioned from the initial position (Figs. 74A, 74C) to the second position (Fig. 74D); Again, deploy in vascular tissue (FIG. 69D). If the longitudinal strength of the snare wire is insufficient to redeploy the device, the snare can be fed into the second inner sheath within the recoverable sheath. This allows for reliable control of the recoverable feature, as shown in FIG. 74B, and the device is retracted into the recoverable sheath and then with an inner sheath that acts as a push rod. Redeploy.
Various use methods of the filter device [00161] Embodiments of the filter device of the present invention can be applied to the end by methods such as thrombectomy, joint resection, stent insertion, angioplasty, and stent implantation. Useful in a way to protect. It should be understood that embodiments of the filter device of the present invention can be used in veins and arteries. An exemplary method is shown in FIGS. 75a-I and 76A-E. In each method, the device 100 is disposed in an unconstrained manner adjacent to the treatment region 730. The procedure of FIGS. 75A-I shows the placement of the delivery sheath 710 (FIG. 75A) and complete deployment within the lumen 10 (FIG. 75B). A conventional treatment device 750 using mechanical energy, electrical energy or other suitable method is used to remove unwanted material 732 from the lumen wall (FIG. 75C). Some debris 734 removed from the lumen wall using the treatment device 750 is then occluded in the bloodstream (FIG. 75C) and taken up by the filter 100 (FIG. 75D). The conventional treatment device 750 is removed (FIG. 75E) and then the recapture sheath 710 is advanced to the retrieval position (FIG. 75F).

  [00162] Next, the captured debris 734 is removed before the device is recaptured, for example, by methods such as therapeutic agent aspiration, delivery or cold soaking. In addition, the entire device and captured debris are recaptured and removed through the same sheath used to recapture the device as shown in FIG. 75G. The device 100 and debris 734 are then withdrawn into the sheath 710 (FIG. 75H) and the sheath is withdrawn from the vascular tissue (FIG. 75I).

  [00163] Similarly, further use of the present invention as an unbound end protection is illustrated in FIGS. 76A-E, where a stent is inserted into a blood vessel before the stent is kept open. A balloon 751 is used to dilate the lesion 732, as in the case of balloon angioplasty, which is often performed. In this method, the balloon catheter is advanced to the lesion site and expanded as shown in FIG. 76B, and the plaque 732 is pushed outward by the balloon (FIG. 76C), thereby reestablishing normal blood flow. Certain material 734 occluded by this method is taken up by the filter (FIG. 76D). Next, as described above, the debris 734 can be removed or the device incorporating the debris can be removed prior to collecting the filter.

  [00164] An additional method that is widely used in the art is to use a bound end protection method as an aid to the method described above (ie, during this method, the device 100 remains bound). is there). The filtration device embodiment of the present invention can also be used for this purpose as shown in FIGS. 77A-77E. Reliable control of the filter 100 is maintained via an integral wire or snare connected to the device 100. The connection between the integral wire or snare and the device 100 is maintained during this method, and in some embodiments can be used as a guide wire. As shown in FIG. 77B, the connection with the device 100 is maintained while performing the method of treating vascular tissue proximate to that location (ie, treating the lesion 732).

  [00165] An example of a protected end protection method is shown in FIGS. 77A-77E. One embodiment of the filter device 100 is deployed distal to the lesion 732 (FIG. 77A) to be treated and initiates treatment (FIG. 77B) to capture the occluded material 734 within the filter 100 (FIG. 77C). Thereafter, prior to recapturing the filter, the debris 734 is removed or alternatively processed within the filter 100 through the sheath as described above. The device 100 is withdrawn into the sheath (FIG. 77D) and removed from the lumen 10 (FIG. 77E).

[00166] The constrained devices (FIGS. 77A, 78A) can also be employed to mechanically displace and remove the embolic material 732 from the blood vessel 10 as in the case of thrombectomy. This provides a simple means for removing and taking up debris without the need for multiple devices to achieve the same purpose. In this method, the constrained device is advanced and deployed (FIG. 78B) downstream of the lesion (FIG. 78A). The bound and deployed filter 100 is then pulled across the lesion 732 (FIG. 78C) and the thrombus is pulled from the vessel wall into the filter 100 (FIG. 78D). The occluded material 734 is then removed via the method described above (FIG. 78E), and the constrained device is drawn into the sheath and removed from the lumen (FIG. 78F).
Drug Delivery Using Filtration Devices [00167] Embodiments of the filter device of the present invention can also be used to deliver medication in a lumen. Intraluminal drug delivery can be achieved using any component of the filtration device. For example, a filter support structure can deliver a drug. In one alternative, the support structure is covered by a multi-lumen structure, and the multi-lumen structure is configured to release a drug. In one alternative, the lumen of the multi-lumen structure is at least partially filled with a drug. In another feature, the lumen of the multi-lumen structure has a port that allows the drug stored in the lumen to be released. In one alternative, the cavity formed in the support member is filled with a material. In one feature, the material in the cavity is a drug. The filter can deliver the drug. In one feature, the material capture structure is coated with a drug.

  [00168] Additional embodiments of the present invention provide the ability to deliver therapeutic agents through the coating of the material capture structure and the support structure. FIG. 79 shows a therapeutic coating 780 attached to the filament 118/461. FIG. 80 shows a composite structure 789 formed by filling one or more cavities formed in the support structure 105 with one or more therapeutic agents or other materials. The cavities can be formed as described above with respect to FIGS. These composite structures are designed to elute the therapeutic agent through a specific elution curve by changing the concentration, density of the therapeutic agent and its location on the filter device components. This therapeutic agent includes, for example, any drug used in treating the body, an anti-coagulant (ie, heparin) anti-proliferative drug that prevents or slows the growth of fibrous tissue, a drug-eluting stent, Other drugs selected from those used in the tube stent can be used.

[00169] FIGS. 81 and 82 illustrate the use of a coating 420, 420a disposed on a support structure as a delivery means for providing a drug into a lumen. FIG. 81 shows the drug 782 in the lumen 424a of the multi-lumen structure as described above with respect to FIGS. As described in FIG. 82, the therapeutic agent 784 fills the lumen 424 of the multi-lumen coating 420 a above the support structure 105. A release port 785 formed on the side of the lumen 424 allows the drug to be pumped into the blood or tissue. Control of the dissolution parameter of the therapeutic agent can be performed through the size or spacing of the release port 785 and / or through the use of a controlled release agent.
Filtration apparatus as prototype products [00170] FIG. 83A, 83E is a perspective view of the filter as a prototype article in accordance with an embodiment of the present invention (FIG. 83A), a plan view (FIG. 83B), a bottom view (FIG. 83C), A side view (FIG. 83D) and an end view (FIG. 83E) are shown. The prototype has the features described above, and common elements have the same reference numbers and are included in these drawings. The support structures 105, 110 are electropolished with an outer diameter of 0.381 mm (0.015 mm) shaped to form two open loops 125, 128 that are substantially equal in diameter of about 25.4 mm (1 inch). Inch) Nitinol wire. The support structure wire used for support structure 105 is ground to a 0.254 mm (0.010 inch) wire diameter and is flexible at each end with a recoverable feature. 240 was used to form (FIG. 28C). A non-wounding feature (in this case, a ball 242) is formed at the end of the wire by processing the wire with plasma. In this case, a radiopaque marker that is a tantalum marker band 248 was mounted below the ball 242. The material capturing structure 115 includes a filter cell 119 having a structure including a filament 118. The filament 118 is an ePTFE monofilament. The filament is attached to the support structure using the method shown in FIG. The cover 185 used to join the ends is a tapered Nitinol tube 186 crimped around the support structure, as shown in FIG.

  [00171] FIGS. 84A-84E are a perspective view (FIG. 84A), a top view (FIG. 84B), a bottom view (FIG. 84C), a side view (FIG. 84D), and a prototype filter according to one embodiment of the present invention. An end view (FIG. 84E) is shown. This embodiment is the same as the embodiment of FIG. 83A. In this embodiment, the material capture structure 115 was replaced with a material capture structure 312 made of an extruded polymeric net material as described above with respect to FIG. This embodiment also shows that the support structures 105, 110 are not in contact at the crossover 106 (ie, separated by a distance “d”).

  [00172] FIGS. 85A and 85E show a perspective view (FIG. 85A), a top view (FIG. 85B), a side view (FIG. 85D), and an end view (FIG. 85C) of a prototype filter according to one embodiment of the present invention. Show. This embodiment is similar to the filter device shown in FIG. 14A, and common reference numbers are used. In this embodiment, the material capture structure is made of a continuous sheet of polymeric material 520, in which a circular hole 521 is formed via mechanical cutting or laser cutting. (As described above for FIG. 61A).

  [00173] FIGS. 86A-86D show a perspective view (FIG. 86A), a plan view (FIG. 86B), a side view (FIG. 86D), and an end view (FIG. 85C) of a prototype filter according to another embodiment of the present invention. Show. This prototype filter is made of a continuous polymer material sheet 520, on which a void of a pattern 522 is formed by a mechanical cutting method or a laser cutting method to form a net-like structure ( FIG. 61C) is formed.

  [00174] FIG. 87 is a perspective view of a prototype filter according to one embodiment of the present invention similar to the embodiment shown in FIGS. 83A-83E above. In this embodiment, the elongated structural members 105, 110 are joined only at one end (ie, end 102). The element of the support structure at the unconnected end is provided with a plasma ball 242 to prevent puncture of the blood vessel and facilitate deployment and retrieval.

  [00175] Some filter embodiments, when deployed, help to maintain the position of the filter by one or more anchoring elements, tissue anchors, or tissue engagement structures Can be included. Various alternative anchoring elements, tissue anchors or tissue engagement structures are described below and can be in a variety of combinations and configurations. 88 shows a first support member 105 having a first end and a second end, and a first end of the first support member 105 or a second end of the first support member 105. It is a perspective view of an intraluminal filter provided with the 2nd support member 110 with which it attached to. In the illustrated embodiment, the first support member 105 and the second support member 110 are each formed of a single wire that extends from at least the first end 102 to the second end 104. . The support member can extend beyond the ends 102, 104 and can be used to form a recoverable feature 240 or other element of the filter, as described below. In one example, the first support member 105 can be formed on a tissue anchor and the second support member 105 can be formed on a recoverable feature. The exemplary embodiment has a recoverable feature 240 at the first end 102 and a recoverable feature 240 at the second end 104. The second support member 110 forms a crossover 106 together with the first support member 105. In this embodiment, the second support member 110 is mounted on the first end of the first support member 102 and on the second end of the first support member 104. The material capture structure 115 extends between the first and second support members 105, 110, the crossover 106, and the first or second end of the first support member 105. In the illustrated embodiment, the material capture structure extends between the first and second support members 105, 110, the first end 102, and the crossover 106. At least one tissue anchor 810 is on the first support member 105 or the second support member 110. In the illustrated embodiment, tissue anchors are provided on the body supports 105,110. In this embodiment, the anchoring element 810 is a separate structure having a body 814 and a tip 812 suitable for intrusion into or through the wall of the lumen 10. A fixation element or tissue anchor 810 is attached to the elongate body using a suitable attachment 805. The mounting portion 805 can be a crimp portion (as shown) or any other suitable technique that couples the securing element 810 to the elongated body. Suitable techniques include, but are not limited to, crimping, other joining techniques with separate holdings, upsetting or other joining techniques with peripheral narrows, soldering, welding, fusion welding, shrink fitting tubes , Epoxy, one wire is placed in each lumen and then includes a multi-lumen collar that is joined or melted together. 91 and 99 show a possible form of a filter structure formed with two elongated support members joined at the ends.

  [00176] FIGS. 89A and 89B show individual filter components that can be assembled into the first configuration shown in FIG. 89C. FIG. 89A shows the proximal end of the filter. The elongated bodies 820, 822 are used to secure the filter structure 115 between the crossover 106 and the end 102. The elongated body 820, 822 extends a considerable length beyond the crossover 106 to the end 826, 824. The recoverable feature 240 is attached to the end 240 and can be formed from any of the elongate bodies 820, 822 in the exemplary embodiment. FIG. 89B shows the end of the filter. The distal end of the filter is formed by elongated bodies 834, 830 joined by end 104. The length of the elongate bodies 830, 834 can be adjusted to couple with the elongate bodies 820, 822 of FIG. 89A to form a properly sized filter. The distal end may also include a recoverable feature 240 and a securing element 810. The final assembled filter is shown in FIG. 89C, where the proximal and distal filter ends are joined together by a suitable coupling connector 805. It is believed that the manufacturing method used to manufacture the filter is simplified through the use of proximal and distal ends. Each of the ends, as described elsewhere in this application, must be manufactured separately in a relatively fewer and easier process than when manufacturing a filter from two elongated bodies of approximately equal length. Can do. In addition, a suitable coupling connector 805 used to join the proximal and distal ends may be used to attach the securing element to the filter frame, for example as shown in FIG. 91, FIG. 95 or FIG. it can.

  [00177] Alternatively, the end of the elongated body may be used to form a fixation element. 90A and 90B show proximal and distal filter ends with elongate member tips modified to form a fixation element. The proximal filter end embodiment shown in FIG. 90A has hooks 825 formed at the ends 824, 826. The embodiment of the distal filter end shown in FIG. 90B has hooks 835 formed at ends 832, 836.

  [00178] FIGS. 90A and 90B can be combined using a suitable mating connector 805 to form a double hook fastening element as shown in FIGS. 95, 104A, 104B and 104C. . Alternatively, the modified distal and proximal ends in FIGS. 90A and 90B can be combined in any combination to be the unmodified distal and proximal filter ends shown in FIGS. 89A and 89B. Also good. FIG. 90C shows one embodiment of one combination that joins the proximal end of FIG. 89A to the distal end of FIG. 90B. Other combinations are possible. For example, the tissue anchor is on the first or second attachment means. Additionally or alternatively, there may be a recoverable feature at the end of the first support structure and a recoverable feature at the second end of the second support structure.

  [00179] These embodiments, together with the other embodiments, include a first support member having one end, a first segment extending from the end, and a second segment extending from the end. The support structure of is shown. There is also a second support member having one end, a first segment extending from the end, and a second segment extending from the end and intersecting the first segment but not attached to the first segment. . First mounting means for coupling the first segment of the first support member to the first segment of the second support member; and the second segment of the first support member coupled to the second segment of the second support member. And second mounting means for coupling to the segments. A tissue anchor is provided on or with the first or second support member. As described in detail above, the first and second segments of the second support member, and the end of the second support member, and the location where the first segment crosses the second segment; There is also a material capture structure mounted between.

  [00180] Further, although FIGS. 89A-90B illustrate elongate body components having the same or substantially the same length, the design is not so limited. Different lengths of elongate bodies can be used to place the anchoring element in an offset position along the elongate body. The elongated body length portions 820, 822, 830, 834 may have different lengths than those shown in the previous example of mounting as shown in FIG. Using elongated bodies of different lengths causes a gap (indicated by “S” in the drawing) between the attachments 805. A broken line indicates the position of each fixed element when the fixed element is moved so as to be stored. The offset gap “S” can cause the anchoring element 810 between the elongated bodies 820, 830 to get caught with the anchoring element 810 between the elongated bodies 822, 834 when stored prior to feeding the filter. (See FIG. 123B). Alternatively, or in addition, the offset spacing “S” is realized by placing the fixing element on the elongated body at a position that provides the desired amount of deflection to prevent the fixing element from being caught. can do.

  [00181] There are a number of different fastening elements that can be used. The fixation element 810 shown in FIG. 92 illustrates a fixation element that can be formed at the end of an elongated body (ie, FIGS. 90A and 90B) using a number of bending and forming techniques. The ends can remain the same diameter as the rest of the elongate body shown in FIG. The end is shaped to provide a desired curve between the body 814 and the tip 812 to engage the surrounding lumen. In one alternative embodiment, the end of the elongate body is shaped to be a sharp or beveled tip 812 by cutting, polishing or otherwise. Additionally or alternatively, the securing element may have a diameter that is smaller than the diameter of the elongated body, as shown in FIGS. 93A, 93B. The anchoring element 810a is reduced at the transition portion 814a to provide the desired final diameter of the tip 812a. The end with such a reduced diameter is then shaped to be the desired curve depending on how the anchoring element engages the surrounding tissue. In one alternative embodiment, the transition portion 814a may be formed of a different material than the body 814, alone or in combination with the tip 812a. The use of different materials or different amounts of materials can provide a saddle or tissue anchor with a flexible tip. For example, one or both of the transition portion 814a and the tip 812a are formed of e-polytetrafluoroethylene (ePTFE), polytetrafluoroethylene (PTFE), poly (ethylene terephthalate) (PET), polyvinylidene fluoride (PVDF), tetrafluoroethylene. -Co-hexafluoropropylene (FEP), or poly (fluoroalkoxy) (PFA), other suitable medical grade polymers, other biocompatible polymers, etc. be able to.

  [00182] FIG. 94 illustrates one embodiment of the proximal end 102 of the filter structure formed by a single wire 803. FIG. The wire 803 begins at the end 803a and curves to one side of the support frame and then curves to the recoverable feature 240. The wire 803 is inverted (803c) to form the opposite side of the recoverable feature 240 and then the side of the support frame opposite the end 803b. A crimp 183 or other suitable fastener is used to maintain the shape and position of the recoverable feature 240. Although this exemplary embodiment describes a technique for forming a single wire for proximal end 102, this technique can also be applied to form distal end 104. The recoverable feature 240 may be shaped other than the illustrated embodiment, and may be formed to resemble the recoverable feature shown in FIGS. 20-22 and 25-28C, for example. Can do. As shown in FIG. 95, a single wire 803 can be used to form a loop 833 at the end 240. This shows a technique of forming both the first support member and the second support member with a single wire. This embodiment also shows the connector 183 in a raised position above the lumen wall. In addition, a fixed element 822 with ends is shown. This is an example of a tissue anchor comprising a first ridge having a proximal opening and a second ridge having a distal opening. The fixing element with both ends can be formed by curving the proximal end and the distal end (see FIGS. 90A and 90B). Alternatively, as shown in FIG. 104A, the fixation element 822 may be an independent component with the body 814 curved into the two tips 812. As shown in FIG. 104B, the fixation element 822 can be coupled to any elongated body using a suitable fixation 805. In the illustrated embodiment, the fixation element 822 is attached to the elongate body 110. The end 812 can also be curved in different directions or at different angles, as shown in FIG. 104C.

  [00183] Soldering, welding, fusion welding, shrink fit tube, epoxy, one wire placed in each lumen, then joined or melted together, multi-lumen collar, wires twisted together, etc. Any of a variety of joining or joining techniques can be used to join the proximal and distal ends together. Alternatively, one or more techniques can be used to join the elongate bodies with or without the addition of securing elements. Next, the area to be bonded is covered with a smooth material to reduce surface defects in order to initiate tissue growth. The bonded area can be covered with epoxy or medical grade silicone or shrink fit tube, or a slotted tube can be placed over the bond and then melted into place. Consider FIGS. 89A and 89B, which shows an example of one alternative technique that provides a smooth surface for the combined area. First, the segments of the thermal shrink tube are long enough to cover the length of the elongated body included in the joining process and are positioned on the elongated body 830, 834 on the ends 832, 836 of FIG. 89B, respectively. Is done. Next, ends 832 and 836 of FIG. 89B couple to ends 824 and 826 of FIG. 89A. Thereafter, the heat shrink tube segments are advanced over the combined area and heated. When the heat shrink tube segment is heated, the tube melts around the bonded area and provides a smooth surface that joins the end 832 with the end 832 and the end 824. Seals the region where it joins the end 836.

  [00184] The joint 805 is an example of a mounting unit that couples the first support member to the second support member. The joint 805 can be used to join elongated bodies together as suggested in the embodiments shown in FIGS. 88, 89A, 89B, 90A, 90B, 94 and 96. Alternatively, the fitting may be used to secure the securing element to the filter room. In yet another alternative, the joint couples the elongated bodies together into a single frame, and means for coupling the securing element to the filter frame at the same location where the elongated bodies are joined. May be provided. Appropriate means for mounting and mounting techniques used to form the joint 805 include, by way of non-limiting example, crimps or other coupling techniques with separate retainers, upsetting with narrowing of the periphery or Other bonding techniques, including soldering, welding, fusion welding, shrink fit tubes, epoxies, and a single lumen are placed within each lumen and then bonded or melted together.

  [00185] The material capture structure 115 can take any of a number of different positions and orientations. FIG. 96 shows one embodiment of a filter of the present invention having two open loop support frames formed by support members 105, 110. The flow in lumen 10 is indicated by arrows. In this embodiment, the material capture structure 115 is disposed within an upstream open loop support structure. On the other hand, the material capture structure may be placed in a downstream open loop support structure (FIG. 97). In another alternative, both the upstream and downstream support frames hold material capture structures 115.

  [00186] There are embodiments of filter devices that include a number of support frames with capture structures equal to the number of support frames without capture structures (eg, FIGS. 13A, 13B, 97A, and 97B). There are other embodiments with more support frames without capture structures than support frames with capture structures. For example, FIG. 14 shows a filter embodiment 190 with more support frames without capture structures than support frames with capture structures. The filter device 190 has two support members 105, 110 disposed adjacent to each other so as to form a plurality of support frames provided for flow in the lumen 10. These support frames may be modified to include anchoring elements in any combination or form described herein. Alternatively, the plurality of support frames are arranged to support the material capture structure across the flow axis of the device 190 or lumen 10. The support members are coupled to each other at end 192 and have at least two bend points prior to being coupled at end 194. Support members 105, 110 cross each other at crossovers 106, 196. Support frame 191 is between end 192 and crossover 106. Support frame 193 is between crossovers 106 and 196. Support frame 195 is between crossover 196 and end 194. As described herein, one or more securing elements can be provided on any or all of the support frames 191, 193, 195.

   [00187] FIG. 98 shows the fixation element 810 engaged within the sidewall of the lumen 10. FIG. In this embodiment, the length and curvature of the fixation element is chosen to remain within the wall of the lumen 10. As shown, the tip 812 is in the sidewall of the lumen 10. In other alternative forms, the length and curvature of the fixation element is selected to engage the lumen 10 by piercing the lumen wall.

  [00188] The fixation element may be a separate element or formed by one of the elongated bodies. Furthermore, the fixation element may be arranged in any of a number of different positions and orientations. FIG. 88 shows a fixation element located approximately halfway between the ends 102, 104 and the crossover 106. An additional securing element is disposed on the end 104. Unlike the example embodiment of FIG. 88 where the fixation elements are on a single support frame, FIG. 99 shows the location of the additional fixation elements on both the support frame and the ends 104,102. FIG. 99 does not show any material capture structure within the frame. In FIG. 99, a securing element 810 is disposed along both elongated bodies 105, 110 approximately midway on the support frame between one end and the crossover. Alternative spacings and orientations of the fixation element 810 are shown in FIGS. FIG. 100 shows the placement of the anchoring element 810 approximately midway between the ends 102, 104 and the crossover 106. FIG. 101 shows an arrangement of anchoring elements similar to FIG. 100 with additional elements placed close to between the crossover 106 and the tips 104, 104. As shown in FIG. 102, one or more fixation elements or hooks can be placed at each of the locations along the structure. FIG. 102 shows a fixed attachment point 805 that fixes two fixation elements 810 to the elongated bodies 105, 110. The anchoring element 810 can be provided separately, or alternatively, one or both of the anchoring elements 810 can be formed from an elongated body. For example, one or more ridges or anchoring elements at a single location along the filter structure are shown in FIGS. 95, 104A, 104B, and 104C.

  [00189] Referring to FIG. 88, the mounting portion 805 can also be used to attach or secure individual securing elements 810 to the elongated body. In FIGS. 103A, 103B, and 103C, individual elements are mounted (FIG. 103A) or on the sides (FIGS. 103A, 103B) to provide the desired orientation with respect to the luminal wall and provide the desired device profile. can do. The coupling structure 805 used to secure the fixation element to the elongated body has been omitted for the sake of detail.

  [00190] The anchoring element may be designed to engage the lumen sidewall at one or more attachment points and attach through a puncture or other method. FIG. 102 shows one or more fixation elements 810 attached to the elongated body at a single attachment location or by a single cover or joint structure 805. FIG. 104A shows a fixed element 822 with both ends comprising a body 814 with two fixed tips 812. FIG. 104B shows a fixed element 822 with ends attached to the elongate body 110. FIG. 104C shows that the tip 812 can be modified to adjust how the tip engages an adjacent lumen wall. FIG. 104C shows one tip 812 that opens proximally and one tip 812 that opens distally.

  [00191] The orientation and fixing position of the body of the different anchoring elements relative to the tip 812 can be. In one embodiment, the tissue anchor includes a coil wound around the first support member or the second support member, and one end raised above the first support member or the second support member. It has. An example of one such tissue engagement or anchor is shown in FIG. FIG. 105 shows a curved wire 817 that extends along and is wound around the elongated body and then bends to place a bent portion between the fixed portion 105 and the tip 812. The degree of curvature of the curved wire 817 can be adjusted to control the force used to puncture tissue or control the amount of fixation force applied to the lumen wall. Alternatively, as shown in FIG. 106, the anchoring element body 817 can be attached to the elongate body 110 by wrapping around the length of the elongate body. FIG. 105 shows an example, which is a coil or open tube with a tissue engaging surface having a helical configuration once the tissue anchor is raised. 105 also shows a tissue anchor having a mounting portion attached to the first support member or the second support member and one end adapted to pierce the tissue, and between the mounting portion and the end 812. The coil 817 is also shown. An optional coating (not shown) may be placed on the coiled wire 817 to maintain a smooth device profile along the elongated body 110.

  [00192] The filter structure may also be secured using alternative securing elements shown in FIGS. 107A, 107B. In some embodiments, the one or more tissue anchors can be formed or attached to a tube attached to the first support member or the second support member. 107A and 107B show a tube or support 821 that is adapted to fit over the elongate body 110. A feature 823 on support 821 is used to engage the side wall of the tube. In the illustrated embodiment of FIG. 107A, the feature has a generally conical shape with a pointed tip similar to a barb. One or more supports 821 can be disposed along the elongate body 810 as shown in FIG. 107B. Alternatively, the feature 823 may be formed from a structure that is integral with the support 821 or may be formed as part of the integral structure. The feature 823 can be formed in a shape different from that shown. The feature 823 can also take the form of a peripheral rib or a void / holding portion. In another alternative embodiment, the support 821 is not a separate segment 821 shown in FIG. 107B, but a continuous piece that extends along the length of the elongated body 110 or most of that length. The size, number and spacing of the one or more features 823 can vary depending on the application. In order to anchor the material capture structure within the inferior vena cava, for example, the feature 823 has a height in the range of about 0.5 mm to about 3 mm and a gap of about 0.1 mm to about 5 mm. be able to.

  [00193] FIGS. 108 and 109 show another alternative securing element. In these alternative embodiments, the tissue anchor is formed from a first support member or a second support member (FIG. 109), or a first support member or a second support member (FIG. 109). (FIG. 108) attached to or formed from a structure or tube. Additionally or alternatively, the tissue anchor is attached to or formed from a structure or tube (FIG. 108) attached to a first support member or a second support member (FIG. 109). Can be. FIG. 108 shows a tissue anchor that is a tube 843 having a tissue engaging surface. In this exemplary embodiment, the tissue engaging surface includes a triangular fixation element 847. The triangular fixing element 847 can be formed on the side wall of the hollow tube 843 as shown in FIG. The hollow tube 843 is then placed on and secured to the elongated body 110. Suitable materials for tube 843 include, for example, nitinol, stainless steel, or the polymers and degradable polymers described above. The cross section of the hollow tube 843 is shown as round, but other cross sections are possible. In one embodiment, the cross section of tube 843 is sized and shaped to accommodate the dimensions and cross section of elongated body 110. Alternatively, instead of forming a triangular fixation element 847 in a tube disposed on the elongated body, the triangular fixation member 847 is attached to the surface of the elongated body 110, as shown in FIG. Formed or formed using the surface. In this exemplary embodiment, the tissue anchor on the first or second support member is formed from the first or second support member. Although the illustrated embodiment shows a fixation element 847 having a generally triangular shape, other shapes are possible. For example, the fixation element 847 can be in the form of an elongated spike or any other suitable shape that engages an adjacent lumen or tissue.

  [00194] In another alternative embodiment shown in FIG. 110, the tube 847 can be modified to form a tissue engaging surface. In another exemplary embodiment, the tissue engaging surface includes a surface feature 862 that is shaped similar to a spike or barb. One way to form the feature 862 is to heat the polymer tube until the surface of the tube is tacky. Next, the surface of the tube is raised to the shape of the feature 862. As shown, the tube 860 is segmented to cover only a portion of the elongated body 110. In another embodiment, the tube is the same length or approximately the same length as the elongated body 110. As an alternative to modifying the surface of the tube 860, the tissue engaging feature 862 may be formed by attaching a securing feature to or through the wall of the tube 860. The tissue engagement feature can be any of a number of different shapes as shown in FIGS. 111A and 111B. FIG. 111A shows a tissue engaging feature 863a having a base 865 that supports a tilted body 866 that terminates at a pointed tip. FIG. 111B shows a tissue engaging feature 864a having a base 865 that supports an overall cylindrical body 867 that terminates in a flat tip. Tissue engaging features are added to the tube 860 by pushing these features through the sidewalls, and when attached, the base 865 is within the lumen of the tube 860 and the bodies 866, 867 are as shown in FIG. And extend through the side wall.

  [00195] FIG. 112 includes another alternative embodiment of a tube-based fixation element. In this embodiment, the tissue engaging surface has a raised configuration. In one embodiment, the tissue anchor is a tube having a tissue engaging surface that, when raised, has a spiral configuration. As shown in FIG. 112, the surface of the tube 870 has been modified to turn when raised with a ridge 872. Once raised, the turn 872 can be a segment as shown. One or more segments can be mounted along the length of the elongated body. Alternatively, instead of a segment, the tube 870 can be the same length or approximately the same length as the elongated body 110 to which the tube is mounted. In another alternative embodiment, the raised portion is formed by inserting a spring or structure thereof below the surface of the tube or segment 860. Additionally or alternatively, the tissue anchor is a coil wound around the first or second support member. As shown in FIG. 106, this alternative can be formed by wrapping one wire (elongate body 110) with another wire or spring (wound wire 817). Wire 110 and rolled wire 817 can then be coated with another material or placed in a suitable shrink tube. When the material or thermal shrink is processed to conform to the wire, the structure formed is similar to that shown in FIG. 112, and the tip 812 (see FIG. 106) extends through the material. Providing additional attachment points to the lumen.

  [00196] It should be understood that the formation of the tissue engaging structure can take any of a number of alternative forms, alone or in any combination. As shown in FIG. 109 and described above, the feature 847 can be cut into the surface of the elongated body. FIG. 108 shows how similar features can be cut into the wall of the tube 843. In addition, the tissue engaging surface can take the form of a raised profile surface above the tube, as shown in FIGS. Additionally or alternatively, the tissue engaging surface is formed by roughening the tube or structure that engages the tissue, thereby increasing the coefficient of friction between the filter and the tissue with which the filter engages. be able to. In some embodiments, the roughening takes the form of surface texturing by mechanical means (sand blasting, bead blasting, engraving, cutting, creasing), chemical means (acid etching), laser cutting, Or it can take the form of an extrusion or an integral part of the molding process.

  [00197] In addition to adding an anchoring or tissue engaging structure to the elongated body, the recoverable feature can include one or more anchoring elements in the elongated body in a number of different ways. It can be mounted or formed from an elongated body. In one embodiment, as shown in FIG. 113, there is a combined tissue anchor and a retrievable feature coupled to the first end or the second end of the first support member. FIG. 113 shows the distal end 104 with the elongated bodies 105, 110 ending at the mounting element or securing feature 183. The securing feature can be a crimp 183 or any other suitable technique for joining the elongated bodies together. Suitable means of attachment and attachment techniques used to form the attachment element or securing feature 183 are merely a non-limiting example of a crimp or other coupling technique with a separate retainer, peripheral narrowing. With upsetting or other bonding techniques involved, soldering, welding, fusion welding, shrink fit tubes, epoxy, and a single wire are placed in each lumen and then a multi-lumen collar that joins or melts together. Including.

  [00198] In this exemplary embodiment, the recoverable feature 240 has a tissue engaging structure with a curved portion 241 of the recoverable feature 240 and a tip 812 for engaging tissue. It is formed from a single wire 811 that is shaped to be 810.

  [00199] In this exemplary embodiment, the diameters of the wires used for the elongated bodies 105, 110 and the recoverable feature 240 are approximately equal, so crimping the wires is not Is the method. Other methods include, but are not limited to, crimping or other joining techniques with separate holders, upsetting or other joining techniques with narrowing the periphery, soldering, welding, fusion welding, shrink fitting tubes , Epoxy, and one wire are placed in each lumen and then include a multi-lumen collar that is joined or melted together.

  [00200] In the embodiment shown in FIG. 114, unlike the embodiment shown in FIG. 113, the wire used to form the recoverable feature 240 is a fixed feature or mounting element 183. End. Instead of using separate wires as shown in FIGS. 113, 114, the ends of the elongated bodies 105, 110 can be used to form a recoverable feature 240 and a fixation element 810. This is an example where one end of the first support member forms a tissue anchor and one end of the second support member forms a recoverable feature. Additionally or alternatively, the recoverable feature formed at the end of the first support structure is formed from the first support structure or is recovered at the end of the second support member. A possible feature is formed from the second support structure. In some embodiments, the tissue anchor is at the end of the first support structure or at the end of the second support structure. FIG. 115 shows the elongate body 105 shaped to pass through the crimp portion 183 and then become the recoverable feature 240. The elongate body 110 is shaped to pass through the crimp 183 and then into a distal open fixation element 810 having a tip 812. FIG. 116A is similar to FIG. 115, but the elongate body 110 is used to form a recoverable feature 240, and the elongate body 105 passes through the crimp portion 183 and then the proximal open fixation. The difference is that the shape is the element 810. FIG. 116B is a cross-sectional view of the crimp portion 183. 116C is a cross-sectional view of FIG. 116A where a spacer 831 is inserted into the crimp portion 183 to help distribute the crimp force and provide a more secure joint.

  [00201] Instead of adding a fixation element at one end, the end can be used to form a fixation or tissue engaging element. 117A and 117B show a perspective view and a bottom view where the securing element 852 is formed with a crimp portion 183 used to hold the elongate body 105, 110. FIG. Either of the elongated bodies 105, 110 can be used to form a recoverable feature 240. FIG. 118 illustrates an exemplary embodiment having a wire 814 separated from the elongated body 105, 110. The wire 814 is formed on the securing element 810a, in which case the ball 811 prevents the wire 814 from pulling through the crimp portion 183. The securing element 810a ends at a hook 812.

  [00202] Modification of the recoverable feature to include a securing element as described with respect to FIGS. 88, 89B, 90B, 96, 99, 113, 114, 115, 116-118 It can also be used to provide one or more securing elements to the recoverable feature embodiment described with respect to FIGS. 20-29. Furthermore, while many of the example embodiments have been described with respect to elongated bodies 105, 110, the present invention is not so limited. Other elongate bodies and / or support structures described herein can also be used interchangeably with elongate bodies 105,110.

  [00203] In other alternative embodiments, all or a portion of the anchoring element can be modified to include a drug. Including the drug can include coating all or a portion of the filter or tissue engaging structure with the drug. Additionally or alternatively, the tissue engaging feature may be configured and configured to hold a drug or drug or drug combination that is released over time or after an initial time delay. it can. FIG. 119 shows one alternative embodiment of the securing element 812 of FIG. 98 having a hollow end portion 812c. The drug elution fixing element 814a can be formed using a needle similar to a hypodermic tube having a desired curvature. Alternatively, the cavity 812c may be formed by hollowing out a portion of the interior of the wire or forming the securing element 812 from a tube. Similarly, the tip of the securing element of FIGS. 93A and 93B can be hollow as shown in FIG. FIG. 120 shows the cavity 812 c at the end of the fixation element 812. The pin 867 and spike 866 of FIGS. 110, 111A and 111B may be modified to include a drug cavity as shown in FIGS. 121 and 122. FIG. 121 shows a tissue engagement feature 863b having a base 865 that supports a tilted body 866 'that terminates at a pointed tip. The cavity 812c extends from the tip into the body 866 ′. FIG. 122 shows a tissue engagement feature 864b having a base 865 that supports a generally cylindrical body 867 'ending in a flat tip. The cavity 812c extends from the flat tip into the body 867 '. The cavity 812c can be filled with any of a variety of drugs. Examples include growth inhibitors or antithrombogenic agents. Furthermore, these or any other anchoring element or tissue engagement structure embodiments may be coated with a drug.

  [00204] FIGS. 123A, 123B, and 124A-E illustrate the deployment and deployment of an embodiment of the filter device 900 of the present invention having one or more fixation or tissue engagement features 810. FIG. . Filter device 900 is an example embodiment of any one of the alternative filter structures described herein having tissue engaging or securing elements.

  [00205] Embodiments of the present invention may be partially deployed to allow a user to verify the position of the filter before fully deploying the device within the target lumen. Partial deployment includes deploying and engaging one or more securing elements in a controlled and reversible manner. After placement of the filter in the lumen, the engagement is reversible because the filter can be partially or fully retracted into the sheath as described herein. The filter is repositioned and then redeployed within the lumen so that the fixation element engages the lumen wall. Furthermore, the design of the filter embodiment of the present invention allows for recoverable operation by approaching the filter from the same direction that is used for deployment. All of the deploying, deploying and retrieving steps can be performed from a single access point.

[00206] The device 900 may be loaded into an intravenous delivery sheath 705 as shown in FIGS. 123A, 123B and described above with respect to FIG. Prior to or after advancement of sheath 705 into vascular tissue using conventional intraluminal and minimally invasive surgical techniques, device 900 is loaded into the proximal end of sheath 705 and then conventional A push rod can be used to advance through the sheath. The push rod 707 is used to advance the device 900 through the lumen of the delivery sheath 705 and to fix the position of the device (relative to the sheath 705) to deploy the device. In one preferred technique, the device 900 is already loaded into the proximal end of the delivery sheath that has been advanced to the desired location within the vascular tissue (FIG. 123B). The device 900 can be preloaded into a short segment of a polymerization tube or other suitable cartridge that allows the device 900 to be easily advanced through the hemostasis valve.

   [00207] When used with a flexible infeed sheath 705, the preformed shape of the device 900 deforms the sheath 705 to conform to the shape of the device (FIGS. 123A, 123B). Accordingly, the flexible, flexible sheath 705 takes the curvature of the stored device 900. The deformation of the delivery sheath 705 helps stabilize the position of the sheath 705 within the vascular tissue and facilitates accurate deployment of the device 900 to the intended delivery location. Unlike this, the non-flexible delivery sheath 705 (the sheath that has not been deformed to accommodate the preformed shape of the device 900), even when the device 900 is stored therein (FIG. 69C), Maintain a cylindrical appearance as a whole. Regardless of the type of sheath used, the position of the device within the sheath 705 is fixed using a push rod 707 on the proximal side of the device 900, and then the sheath 705 is pulled out in the proximal direction, Device feeding is realized. As device 900 exits the distal end of sheath 705, the device takes the form of a preformed device.

  [00208] The symmetrical shape of the device (see, for example, the devices of FIGS. 15, 16A, 96, 97, 90C, 99, and 88) allows the device from multiple access points within the vascular tissue. 900 facilitates deployment and retrieval. Similar to the other unconstrained filter devices described herein, the device 900 can be positioned as shown in the vascular tissue in the inferior vena cava 11 just below the renal vein 13 (FIG. 70). A thigh access path (FIG. 126A) and a cervical access path (FIG. 125A) are shown. The thigh access path and the cervical access path can each be used for device deployment, repositioning and retrieval. Alternatively, the vena cava may be accessed via forearm or antecubital access for device deployment, repositioning and retrieval. The placement or orientation of the fixation element or tissue engagement structure can be modified as needed to facilitate the desired placement and retrieval technique.

  [00209] Device recovery is most preferably performed by endoluminal capture using one of the recoverable features described herein (ie, FIGS. 27A-E). The recoverable features described herein are designed to function satisfactorily using the two commercially available snares shown in FIGS. 71A and 71B. A single loop gooseneck snare 712 is shown in FIG. 71 within the retrieval sheath 710. Multiple loop snares 714 are shown in FIG. 71B inside the recovery sheath 710. These conventional snares are controlled by a surgeon using a flexible integral wire.

  [00210] The procedure for recapturing and removing the device from the body cavity is illustrated and described above with respect to FIGS. 72A-C. A similar collection procedure is used for the embodiment of the filter device 900 as shown in FIGS. 125A-125C. In this description, the device 900 is placed in the vena cava. 125A, 125B and 125C show an example cervical recovery. Device 900 is shown in a blood vessel, where the flow in the blood vessel first passes through the material capture structure and then through the open support frame. 126A-C show an example collection from the thigh. Device 900 is shown in a lumen, so that the flow in the lumen first flows through the material capture structure and then through the open support loop. The folded snare is advanced through the infeed sheath to the proximal end of the recoverable feature 240. When in the desired position, the snare 712 is exposed and takes the shape of a pre-defined expanded loop (FIGS. 125A and 125B). The loop shape is placed on the recoverable feature 240 as shown in FIGS. 125B and 126B. Desirably, the recoverable features of the present invention are located in a position opposite and in contact with the lumen wall so that the features are easily captured by a recoverable device such as a snare. be able to.

  [00211] Next, the snare device 900 is retracted into the sheath 710, or alternatively and more preferably, the retrieval sheath 710 moves the snare 712 as the sheath 710 is advanced over the device 900. The device is advanced over the apparatus 900 while maintaining a reliable control state. Advancement of the retrieval sheath 710 over the device 900 facilitates non-wound removal of the device 900 from any tissue that has grown in or around the device 900. Furthermore, the retrieval action that tends to fold the device radially inward (FIGS. 125C and 126C) also facilitates removal from any tissue layer formed on the device while the fixation element is withdrawn from the lumen wall. To. In addition, retrieving the filtration device by pulling a portion of the filter structure (ie, the recoverable feature) includes a spiral element and a securing element or a tissue engaging structure attached to the securing element when opposed to each other. Will be removed from the lumen wall. When the device 900 is retracted into the sheath 710, the preformed shape of the device 900 pushes the support member away from the lumen wall, which also retrieves or disengages the fixation element from the lumen wall. It helps to get into the state (FIG. 126D).

  [00212] Having described various techniques and alternatives for placing, deploying, and retrieving filters, the following describes how to place a filter within a lumen wall. 123A and 123B illustrate one embodiment of the process of advancing the sheath holding the filter through the lumen. FIG. 124A illustrates one of the steps of deploying a portion of the filter from the sheath into the lumen and engaging the lumen wall with the fixation device while maintaining substantially all of the filter material capture structure within the sheath. Embodiments are shown. As shown in FIG. 124A, the recoverable feature 240 and the at least one securing element 810 exit the sheath 705. The remaining portion of the filter, including the material capture structure, is still in the sheath 705. Next, FIGS. 124B and 124C illustrate the steps of deploying the support frame from the sheath to a position along the lumen and engaging the lumen. The support frame is also used to engage the fixation element with the lumen wall. The shape and design of the support frame itself generates a radial force that helps to secure the filter in place and maintain the position of the filter within the lumen. FIG. 124C shows the support frame deployed from the sheath 705 and open along the lumen 10. Two fixation elements 810 engaged with the lumen wall are shown. A crossover 106 is also provided. A portion of the material capture structure 115 adjacent to the crossover 106 is also shown exiting the sheath.

  [00213] The next step is to deploy the material capture structure of the filter from the sheath to a position that traverses the lumen. FIG. 124D shows the material capture structure exiting the sheath. The recoverable feature 240 is still in the sheath (shown in phantom).

  [00214] FIG. 124E illustrates a fully deployed filter 900. FIG. The second recoverable feature 240 is in a position opposite the lumen wall and the material capture structure is deployed across the lumen. FIG. 124E also illustrates one embodiment of deploying the filter's recoverable feature 240 from the sheath 710 after deploying another portion of the filter.

  [00215] In one embodiment, the filter shown in FIG. 124E may be modified to include a securing element 810 on or near both recoverable features 240. In one such embodiment, when the last portion of the filter and the second recoverable feature exit the sheath 710 (movement from FIG. 124D to FIG. 124E), at the second recoverable feature or Another securing element 810 in its vicinity engages the lumen wall.

  [00216] In another feature, the method of deploying the filter can include deploying the filter crossover structure in the lumen before or after deploying the filter material capture structure. One feature of this process is illustrated in FIGS. 124B and 124C. These two figures show a partially deployed filter 900 with one recoverable feature and three engagement elements 810 exiting the sheath 710 and in contact with the lumen. Further, in this figure, the crossover 106 has exited from the sheath 710. In this deployment phase, the engagement feature 240 faces one lumen wall and the crossover 106 faces another wall that generally faces the recoverable feature 240. The deployed open support frame extends along the lumen between the crossover 106 and the engagement frame 240.

  [00217] The foldable nature of the filter of the present invention allows the filter to be retrieved from the same direction that the filter was deployed and from the direction opposite to the direction in which the filter was deployed. Embodiments of the present invention allow the retrievable features to be reliably placed against the lumen wall and provided in a manner that is easy to snare. The filter can be deployed in the inferior vena cava using the femoral access path. Next, as shown in FIG. 125A, the filter can be retrieved using the access path from the neck or superior vena cava. Similarly, a filter placed in the vena cava using the cervical deployment tract can be removed using the femoral approach shown in FIG. 126A. In one particular example, during the advancement process described above, recovery is performed by manipulating the snare towards the filter in the same direction as used. Next, the step of engaging the snare with a retrievable feature of the filter disposed opposite the lumen wall is performed. In one alternative technique, the step of manipulating the snare toward the filter in the opposite direction to that used during the step of advancement is performed. Next, the step of engaging the snare with a retrievable feature of the filter disposed opposite the lumen wall is performed.

  [00218] The technique of placing and retrieving filters can be modified in other ways as well. For example, placing the filter as described above can be adjusted to include deploying the filter's recoverable features from the sheath prior to deploying a portion of the filter. In another alternative, the step of placing the filter's recoverable features against the lumen wall can be performed before or after the crossover is placed in the lumen. Additionally or alternatively, the step of deploying the filter's recoverable feature may include placing the filter's recoverable feature opposite the lumen wall.

  [00219] Further, repositioning the filter 900 from one lumen position to another is accomplished in a manner similar to that described above with respect to FIGS. 74A-74D. Many embodiments of the apparatus 900 are at least as shown in the non-limiting examples of FIGS. 90C, 91, 99, 96, 97, 94, 89C, 89A and 88. It has one non-wounding end. In this regard, a non-wounding end is an end that does not have any fixation or tissue engaging features. Due to the non-wounding design of these filter device embodiments, the device 900 may be completely captured (see FIG. 74C) or only partially recaptured in the retrieval sheath 710 (see FIG. 74B). A position change of the device 900 can be realized. By maintaining a portion of the device 900 having an anchoring element held within the sheath 710, the non-wound end is moved to the desired position and the rest of the device is deployed and engaged with the anchoring element. Before you can confirm that you are in the required position. The non-wounding design of the device 900 allows the device to be partially deployed so that only the non-wounded end is in the lumen. The partially deployed device can then be pulled along the lumen wall to the desired location. When in the required position, the rest of the device is then released from the sheath, thereby allowing the anchoring element to engage the lumen wall when the anchoring element is released from the sheath. Since the filter device of the present invention can be deployed in and retrieved from vascular tissue using a sheath of approximately the same dimensions, the infeed sheath and the retrieval sheath are assigned the same reference number. ing. Thus, the device of the present invention can be deployed into vascular tissue from a delivery sheath having a first diameter. The device can then be retrieved from the vascular tissue using a retrieval sheath having a second diameter that is 2 Fr greater than the first diameter (1 Fr = 0.013 inches = 1/3 mm). Alternatively, the second diameter may be 1 Fr greater than the first diameter, or alternatively, the first diameter may be approximately the same as the second diameter.

  [00220] Although many of the features and alternative designs of the fixation elements and tissue engagement structures have been shown and described with respect to FIGS. 88-125, it should be understood that the invention is not so limited It is. The features and alternative embodiments described with respect to FIGS. 83A-87 can also be applied to various filters having fixation elements and tissue engaging structures. Further, the filters and embodiments described with respect to FIGS. 2A, 2B, 2C, 6C, 7D, 7G, 9A-10B, 11-19, 64A-67, and 69A-87 are illustrated in FIG. Any of the fixation elements or tissue engaging structures described or shown with respect to 88-126D may be included.

  [00221] It should be understood that the present invention is merely an example of a number of alternative filtration device embodiments of the present invention in many respects. Changes can be made in detail, particularly in the shape, dimensions, materials and arrangement of the components of the various filtration devices without exceeding the scope of the various embodiments of the present invention. Those skilled in the art will appreciate that the exemplary embodiment and description thereof are merely exemplary of the invention as a whole. Although some principles of the present invention have been clarified in the exemplary embodiments described above, those skilled in the art will understand the structure, arrangement, ratio, elements, materials and methods of use of the present invention. It will be appreciated that it can be utilized in practice and otherwise specifically adapted to a particular environment and operable conditions without departing from the scope of the present invention.

Claims (33)

In the intraluminal filter,
A first support having a first end and a second end;
A second support attached to a first end of the first support member or to a second end of the first support member and forming a crossover having the first support member; ,
A material capture structure extending between the first and second support members, the crossover, and a first end or a second end of the first support member;
An intraluminal filter comprising at least one tissue anchor provided on the first support member or the second support member. The intraluminal filter of claim 1,
The second support member is an intraluminal filter attached to the first end of the first support member and the second end of the first support member. The intraluminal filter of claim 1,
The first support member and the second support member are an intraluminal filter formed by a single wire. The intraluminal filter of claim 1,
The first support member forms a tissue anchor;
The second support member is an intraluminal filter that forms a recoverable feature. The intraluminal filter of claim 1,
An intraluminal filter further comprising a recoverable feature at the first end and a recoverable feature at the second end The intraluminal filter of claim 1,
An intraluminal filter further comprising a combined tissue anchor and a recoverable feature coupled to the first end or the second end of the first support member. The intraluminal filter of claim 1,
An intraluminal filter further comprising a mounting element that couples the first support member to the second support member. The intraluminal filter according to claim 7,
The intraluminal filter, wherein the attachment element further comprises a tissue anchor. The intraluminal filter of claim 1,
The intraluminal filter, wherein the at least one tissue anchor is formed on a surface of the first support member or the second support member. The intraluminal filter of claim 1,
A lumen in which at least one tissue anchor on the first support member or the second support member is disposed between the crossover and the first end or the second end. Inner filter. The intraluminal filter of claim 1,
The intraluminal filter, wherein the tissue anchor comprises one or more tissue anchors at a location on the first or second support member. The intraluminal filter of claim 1,
The intraluminal filter, wherein the tissue anchor is formed from or attached to a tube that covers at least a portion of the first support member or the second support member. The intraluminal filter of claim 1,
The intraluminal filter, wherein the tissue anchor is a tube having a tissue engaging surface. The intraluminal filter according to claim 13,
The intraluminal filter, wherein the tissue engaging surface comprises a raised configuration. The intraluminal filter according to claim 13,
The raised configuration comprises an intraluminal filter comprising a helical configuration. The intraluminal filter of claim 1,
The intraluminal filter, wherein the tissue anchor comprises a coil having at least one end adapted to puncture tissue and wound around the first member or the second support member. In the filter,
A first support member having a first end and a second end;
A second support member having a first end and a second end;
The first support member, the second support member, the point at which the first end of the first support member is coupled to the first end of the second support member, and A filter structure that is suspended between a first support member and a transverse point without being coupled to the second support member;
A tissue anchor at least one of the second end of the first support member or the second end of the second support member. The filter of claim 17,
The filter further comprising a tissue anchor at a point where the first end of the first support member joins to the first end of the second support member. The filter of claim 18.
The filter, wherein the tissue anchor is formed from the first support member or the second support member. The filter of claim 17,
The filter further comprising a recoverable feature at a point where the first end of the first support member joins the first end of the second support member. The filter of claim 20,
The recoverable feature is a filter formed from the first support member or the second support member. The filter of claim 17,
A third support member having the first end and the second end;
A fourth support member having the first end and the second end and coupled to the third support portion;
The second end of the third support member is mounted on the second end of the second support member;
The filter, wherein the second end of the fourth support member is attached to the second end of the first support member. The filter according to claim 22,
A filter in which a tube is used to couple the third support member to the second support member or to couple the first support member to the fourth support member. 24. The filter of claim 23.
The filter, wherein the tube further comprises a tissue engaging feature. In a method of placing a filter in a lumen,
Advancing a sheath containing a filter through the lumen;
Deploying a portion of the filter from the sheath into the lumen to engage a lumen wall while maintaining substantially all of the material capture structure of the filter within the sheath;
Deploying a material capture structure of the filter from the sheath to a location across the lumen. 26. The method of claim 25, wherein
Deploying the filter crossover structure within the lumen before or after deploying the filter material capture structure. 26. The method of claim 25, wherein
Steering a snare towards the filter in the same direction as used during the advancing step;
Engaging the snare with a recoverable feature of a filter disposed opposite the lumen wall. 26. The method of claim 25, wherein
Maneuvering the snare toward the filter in a direction opposite to the direction used during the advancing step;
Engaging the snare with a recoverable feature of a filter disposed opposite the lumen wall. 26. The method of claim 25, wherein
Deploying the filter's recoverable features from the sheath prior to placing the material capture structure. 26. The method of claim 25, wherein
Deploying the filter's recoverable feature from the sheath after deploying the material capture structure. A method according to claim 29 or claim 30, wherein
Deploying a filter recoverable feature further comprises disposing the filter recoverable feature opposite a lumen wall. 26. A method of placing the filter of claim 25 in a lumen.
Deploying a portion of the filter further comprises engaging a lumen wall with a fixation device attached to the filter. 26. A method of placing the filter of claim 25 in a lumen.
Deploying a portion of the filter further comprises engaging the lumen wall with a radial force generated by a filter support structure.

Images